Recovery after Hip Fractures: Influence of Bipolar Hemiarthroplasty on Physical Disability and Social Dependency in the Elderly

Abstract

Surgical treatment of femoral neck fractures is associated with a significant impact on quality of life. The aim of this study was to determine the long-term influence of displaced femoral neck fractures treated by bipolar hemiarthroplasty on the activities of daily living, quality of life and social dependency. We studied 487 geriatric patients treated in the years 1989 to 2003. At the beginning of follow-up in 2004, 166 patients were alive and evaluation was carried out on 145 patients (87.3%) at 91.3 (14 - 244) months postoperatively by a standardized questionnaire. All enrolled patients had been treated with cemented bipolar hemiarthroplasty for a displaced femoral neck fracture. Patients were evaluated concerning their average pre- and postoperative ability to walk, the need for assisting devices, type of residency and the SF-12® Score. Femoral neck fracture and hemiarthroplasty had a significant influence on all recorded aspects of quality of life. Even though almost two thirds of the patients needed assisting devices to walk after surgery, about two thirds returned to their original type of accommodation and the majority reached their original degree of mobility. Compared to a normal population no significant impact was observed on the quality of life measured by the SF-12® score. We consider bipolar hemiarthroplasty an effective treatment option for displaced femoral neck fractures in geriatric patients. Most patients returned to their original type of accommodation and level of mobility, even though the majority required a number of assisting devices to do so.

Treatment of Femoral Neck Fracture with a Minimal Invasive Surgical Approach for Hemiarthroplasty – Clinical and Radiological Results in 180 Geriatric Patients

“…16 patients (10%) were temporarily placed in a short-term care facility. This coincides with the results of Schneppendahl et al [41]. In his long-term follow-up of patients who underwent BHH because of femoral neck fracture, about 2/3 of patients returned to their original type of accommodation, and the majority reached their original degree of mobility.…”

A Case Report of Femoral Neck Fracture in an Elderly Patient Managed by Non-operative Korean Medical Treatment : 42 Months Follow-up

“…However, the risk of surgery or total hip replacement, such as an increased operating time and bleeding volume, may be greater than internal fixation. In addition, postoperative complications such as dislocation, infection, and loosening of the fixation screw may occur, so careful consideration is necessary [15]. So, some practitioners advocate non-operative treatment [16,17].…”

Decreasing mortality after femoral neck fracture treated with bipolar hemiarthroplasty during the last twenty years

“…In addition to the risk of persistent physical limitation up to social dependency [14], a significant mortality after hip fractures is described. During the first year after femoral neck fractures a mortality of 11-36 % is reported [1, 15-17, 27].…”

“…As a result of femoral neck fractures patients do not only have a significantly increased risk of permanent physical disability and social dependency, but these injuries also are associated with significant mortality [13,14]. The one-year mortality rates reported in literature range from 11 to 36 % [1,[15][16][17].…”