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The Transition to an Anterior-Based Muscle Sparing Approach Improves Early Postoperative Function but is Associated with a Learning Curve
Published on: September 7, 2022
HIP FRACTURE: POST-OPERATIVE EVALUATION OF CLINICAL AND FUNCTIONAL OUTCOMES
Marcelo Teodoro Ezequiel Guerra1, Thomas Alexandre Thober2, André Vicente Bigolin3
1MSc in Medicine from UFRJ. Orthopedist and Coordinator of Orthopedics and Traumatology Module, ULBRA; Head of Orthopedics and Traumatology Service, ULBRA; Titular Member of SBOT and SBTO; International Affiliate of AAOS.
Objective:
To evaluate the clinical and functional outcomes from patients undergoing surgery to treat hip fractures, with regard to the ASA score and time spent waiting for definitive surgical treatment.
Method:
Over a one-year period, 154 patients with hip fractures, aged 65 years and over, underwent operations. Data on the preoperative ASA score and the time spent waiting for the operation were obtained. Two years after the operation, Zuckerman's Functional Recovery Score (FRS) questionnaire was used to assess the patients' current functional capacity.
Results:
Mortality during the first postoperative year differed between patients with ASA 3 or 4 and those classified as ASA 1 or 2 (significant data; p < 0.05). Mortality up to the end of the second postoperative year was significantly higher (p < 0.05) in the ASA 3 or 4 group. The preoperative ASA score did not demonstrate any significant relationship with the patients' current functional capacity (p > 0.05). There was no significant difference between the group operated within 48 hours of admission and the group operated after 48 hours, in relation to mortality or current functional capacity (p > 0.05). The group aged 80 years and over showed significantly higher mortality (p < 0.05) than the group aged 65 to 79 years up to the end of the second postoperative year.
Conclusion:
The preoperative ASA score and an age of 80 years or over may be considered to be factors associated with higher mortality two years after hip fracture surgery. In isolation, time spent waiting for surgery was not significant.
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