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Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
Published on: August 17, 2017
Report on the Japanese Orthopaedic Association's 3-year project observing hip fractures at fixed-point hospitals
Keizo Sakamoto1, Toshitaka Nakamura, Hiroshi Hagino
1Department of Orthopaedic Surgery, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan.
Insights
Hip fractures significantly decrease daily living activities for older adults one year post-surgery. While Japanese hospitalization is longer, the 1-year hip fracture mortality rate remains lower than in other countries.
Area of Science:
- Gerontology
- Orthopedic Surgery
- Public Health
Background:
- Hip fractures pose a significant health challenge for elderly populations.
- Assessing long-term outcomes is crucial for effective patient management and public health strategies.
Purpose of the Study:
- To evaluate the one-year disability and mortality rates following hip fractures in patients aged 65 and older.
- To analyze the impact of hip fractures on Activities of Daily Living (ADL) in the Japanese elderly population.
Main Methods:
- A prospective study involving 1992 patients aged 65+ with hip fractures across 158 orthopedic hospitals in Japan (1999-2001).
- Assessment of ADL using long-term care insurance criteria one year post-initial visit.
- Analysis of surgical timing, hospitalization duration, and mortality rates.
Main Results:
- A significant decrease in ADL scores was observed one year after hip fracture, with a 24.1 percentage point drop in patients able to maintain independence.
- The overall one-year mortality rate was 10.1%, with 70 patients dying before surgery.
- Average hospitalization duration was 49.8 days, with surgery occurring a mean of 14.3 days after admission.
Conclusions:
- Hip fractures lead to a substantial decline in functional independence (ADL) one year post-injury.
- Despite longer hospitalization periods in Japan compared to other nations, the one-year mortality rate for hip fractures is comparatively lower.
Background:
The aim of this study was to assess the disability and mortality of hip fractures 1 year after initial visit (postoperatively) at fixed-point hospitals selected by the Japanese Orthopaedic Association Committee on Osteoporosis.
Method:
A total of 158 core orthopedic hospitals were selected for participation in this research. Subjects were all aged 65 years and older with hip fractures at the selected hospitals between January 1, 1999 and December 31, 2001. A prognostic survey of activities of daily living (ADL), assessed by the long-term care insurance criteria established by the Ministry of Health, Labour, and Welfare of Japan was performed 1 year after the initial visit.
Results:
A total of 1992 hip fractures in patients aged 65 to 111 years were treated over the 3 years from 1999 to 2001. Among the 1992 patients, 4537 had femoral neck fractures and 6217 had trochanteric fractures. Surgical treatment was chosen for 85.6% of the femoral neck fractures and 88.2% of the trochanteric fractures. The mean duration from fracture to admission was 3.1 days, and the mean duration from admission to surgery was 11.2 days. The mean duration from surgery to discharge over the 3-year period was 49.8 days. Before hip fracture, the ratio of patients with J1 ("able to go out freely utilizing public transportation") or J2 ("able to visit immediate neighbors independently") on the long-term care insurance criteria was 50.9%. At 1 year after the initial visit, that result represented a decrease of 24.1 percentage points before hip fracture. A total of 70 patients died before undergoing surgery. In the present study, the 1-year mortality rate for the entire patient population over the 3-year period was 10.1%.
Conclusions:
Hip fracture patients show a decrease in the ADL score 1 year after the initial visit. Compared to other countries, the duration of hospitalization is longer in Japan, but the mortality rate is lower.
