[Hip fractures in the elderly. Observational study in an unit of intermediate care]

ASL TO4-ICU inpatients with hip fracture over 5 month-period were 45, 12 men and 33 women, average age 81. In 42 patients the fall was accidental or environment-related, and in 40 cases it occurred at home. More than 3 coexisting diseases were found in 22 patients (48%), and polipharmacotherapy with more than 3 drugs in 27 (60%). Only 4 (8%) patients presented a diagnosis of osteoporosis, and only one treated with antiosteoporotic drugs. Before the fracture occurred, 35 (77%) subjects walked without help; 28 (62%) were functionally independent, 17 (38%) dependent; cognitive impairment was diagnosed in 11 (24%) patients. Side-fracture was intracapsular in 17 (38%), extracapsular in 28 (62%). Surgery treatment was osteosinthesys in 26 (58%), endoprosthesis in 11 (24%), total hip prosthesis in 8 (18%). Surgery-timing was of 3 or more days in 23 (51%) patients. In the elderly osteoporosis is underdiagnosed and undertreated, and surgery of hip fracture is always delayed.