Recovery of pre-injury functional state following operative treatment of displaced femoral neck fractures; a prospective cohort study

Abstract

Background The incidence of fracture neck of femur (FNF) has been projected to increase significantly. This study sought to determine the recovery of preinjury functional state following operative treatment of displaced FNF. Materials and methods A six-month prospective cohort study was conducted at Kenyatta National Hospital (KNH) and PCEA Kikuyu Mission Hospital (KMH) between November 2008 and May 2009. Sixty patients were enrolled using a pre-tested questionnaire . The Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scores were used. The functional outcome measures included pain, stiffness and activities of daily living (ADL). Stratification and subgroup analysis were done especially based on age. Student's t -test and χ 2 test were used for comparison between variables as appropriate with a p < 0.05 being considered statistically significant. Results Majority of the patients recruited were males (68%) with a mean age of 51.6 years. Eighty eight percent of the patients had a mean negative early functional outcome score. Hemiarthroplasty (HA) and Total Hip Arthroplasty (THA) had comparable early post-operative functional outcome while Osteosynthesis (OS) had a poorer ADL outcome. Prolonged hospital stay was associated with a poor ADL outcome ( p = 0.020). Use of the antero-lateral approach to the hip was associated with a better ADL outcome in patients older than 50 years ( p = 0.007). Conclusions At three months post-operatively, most patients have not fully recovered their pre-injury level of function and independence. Both HA and THA are associated with better early functional outcome compared to OS. Study type Original research.

Self‐reported involvement in road traffic crashes in Kenya: A cross‐sectional survey of a nationally representative sample

“…Evidence shows that even at 3 months postsurgical intervention, most of these patients do not recover fully to their preinjury level of function. 10 …”

“…Moreover, 51.7% of these patients needed surgical intervention for injuries mainly involving the limbs, head, and neck. Evidence shows that even at 3 months postsurgical intervention, most of these patients do not recover fully to their preinjury level of function 10 …”

“…Evidence shows that even at 3 months postsurgical intervention, most of these patients do not recover fully to their preinjury level of function. 10 There seems to be a link between sociodemographic factors and the occurrence of RTCs, with the resulting injuries disproportionately affecting the poor. 11 According to Odero et al, 12 men in the most economically productive age group (20−49) are the most affected, contributing up to 75% of injuries compared to their female counterparts.…”

Prediction Models for Prognosis of Femoral Neck–Fracture Patients 6 Months after Total Hip Arthroplasty

“… 5 Some patients are unable to regain their preinjury level of function after THA. 6 Deficits in lower-limb strength, balance, and gait may persist for months to years after surgery. 7 , 8 Predicting the prognosis of these patients undergoing THA is still of great importance to provide timely interventions for those at high risk of poor outcomes after THA treatment and improve their prognoses.…”