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Hip fractures in extremely old patients.
Mehmet Kapicioglu1, Ali Ersen1, Yavuz Saglam1
1Istanbul University, Istanbul Faculty of Medicine, Orthopedics and Traumatology Department, Istanbul 34093, Turkey.
Journal of Orthopaedics
|September 30, 2014
Summary
Hip fractures in patients over 90 present significant challenges, leading to increased mortality and disability. Treatment outcomes varied, with bipolar cemented hemiarthroplasty showing higher mortality in later years compared to proximal femoral nailing.
Area of Science:
- Geriatric Medicine
- Orthopedic Surgery
- Trauma Surgery
Background:
- Hip fractures are a common and serious injury, particularly in the elderly.
- Patients over 90 represent a unique demographic with increased vulnerability and complex care needs.
Purpose of the Study:
- To describe hip fracture cases in patients older than 90 years.
- To identify predictors of functional decline, complications, and mortality in this population.
Main Methods:
- Retrospective analysis of 32 patients aged over 90 treated for hip fractures.
- Mean age of patients was 92.8 years, with a mean follow-up of 2.02 years.
- Comparison of outcomes between proximal femoral nailing (PFN) and bipolar cemented hemiarthroplasty (BCH).
Main Results:
- Mortality rates were similar between PFN and BCH in the first year post-surgery.
- BCH showed significantly higher mortality in subsequent years compared to PFN (p=0.035).
- Cardiac disease was associated with increased mortality (p=0.054).
Conclusions:
- Hip fractures in the extremely elderly (>90) are associated with substantial mortality and functional impairment.
- Treatment choice may influence long-term survival, with PFN potentially offering better outcomes than BCH in later years.
- Comorbidities like cardiac disease exacerbate mortality risks in this fragile patient group.
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