Abstract
Hip fractures are frequent due to osteoporosis and old age. The incidence of the second hip fracture had been reported as 5–9%. Subcapital displaced fractures in the elderly are treated sometimes with hip hemiarthroplasty. Our aims was to evaluate patients with bilateral no simultaneous hip fracture treated with hemiarthroplasty at our institution.
Material and methods.- Twenty-two patients, 19 women and 3 men, were evaluated with a mean age of 79 at the initial fracture and 82 at the subsequent fracture. In 13 the first fracture was on the left and 9 on the right. All were of Garden grade IV. One of the fractures occurred from 1994 to 2003. The mean hospital stay was 18 days for the first fracture and 14 for the second. The second fracture happened a mean of 4 years after the first one (1 month to 9 years). This report is based on 14 of these patients, with more than one-year follow-up. The others 8, 6 had died and 2 were missing.
Results.- Walking capacity: previous to the first fracture 11 walked more than 1000 meters, 3 between 100 and 500 meters. Outdoors: after the first fracture 6 walked without help, 3 used one cane and 3 used a walker or two canes, and 2 were unable. After the second fracture 1 walked without help, 2 used one cane, 5 used two canes or walker and 6 were unable. Indoors: after the first fracture 12 walked without help, 2 were able with the help of one cane, 2 with two canes. After the second fracture 2 walked without help, 3 used one cane, 7 used two canes or walker and 2 were unable to walk. Dressing: all were independent before; after the first 12 and after the second 7. Bathing: 13 were independent before, after the first 9 and after the second 5. Feeding: all were independent before, after the first 11 and after the second 6. Toilet: 13 were independent before, after the first 9 and after the second 4. Shopping: 11 were independent before, after the first 5 and after the second 0. Housekeeping: 11 independent before, 1 with help and 2 unable, after the first 4 were independent, 5 need help and 5 unable, and after the second 1 was able, 3 with help and 11 unable after the second. Public transport: 3 were able and 11 unable before the fracture, after the first fracture 3 were able and 11 unable, after the second fracture none was able, 2 with help and 12 unable. Finances: 2 were able and 12 unable before the fracture, after the first fracture 2 were able and 12 unable, and after the second 2 with help and 12 unable. Eight were limping and 6 had groin pain.
Conclusion.- Previous to the first fracture walking capacity was good in this age group. Following the first hemiarthroplasty patients deteriorate in their walking capacity and others activities of daily life and much so after the second one. Limping or groin pain was present in all after the second fracture with more than one year follow-up.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
