Abstract
Objective: The objective was to evaluate mortality and ambulatory ability for elderly patients over 80 years with a femoral neck fracture treated surgically. A strategy for managing elderly patients with various problems is proposed.
Materials and Methods: From January 1, 1998 to March 31, 1999, 122 patients with femoral neck fractures were treated in our hospital. Sixty patients aged over 80 years were chosen from this series for the present study. The 60 patients included 50 women and 10 men with a mean age of 87.1years (range 80–97years). The fractures included 26 intracapsular and 34 extracapsular fractures. The mean follow-up period was 12.9 months. The patients were classified into three groups according to age: group A (80–84 years old), group B (85–89 years old) and group C (over 90 years old). The following parameters were evaluated: duration between injury and operative treatment, duration of hospital stay, senile dementia, prefracture and postoperative walking abilities, and mortality. Walking ability was graded on a scale of 0–4: 0, free gait; 1, gait with a walking stick; 2, gait with a wheelchair; 3, ability only to walk a few steps; and 4, bedridden.
Results: The rates of regained postoperative walking ability to better than grade 2 were 72.2% (13/18) in group A, 65.2% (15/23) in group B and 84.2% (16/19) in group C. These patients were followed until death or for at least one year. The overall mortality rates were 11.1% (2/18) in group A, 17.4% (4/23) in group B and 10.5% (2/19) in group C.
Conclusion: In cooperation with internists, medical staff and family members, we were able to overcome various problems and achieve good clinical outcomes. Cooperation of family members was needed for the elderly patients to return to where they had lived before the trauma and to improve their quality of life.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
