Treatment of the Hip Fractures in the Elderly over 80 years old

Chung, Phil Hyun; Hwang, Chung Soo; Kang, Suk; Kim, Jong Pil; Kim, Young Sung; Lee, Sang Ho; Park, Chong Suck

Abstract

PURPOSE
The aim of this study was to determine if aggressive surgical treatment for hip fractures in elderly patients over 80 years of age is reasonable despite the many complications.
MATERIALS AND METHODS
From Jan. 2000 to May 2005, 36 cases of femur neck and intertrochanteric fractures in patients over 80 years of age, who were followed up for more than one year after surgery, were selected. According to the fracture types, the patients were treated with cemented bipolar endoprothesis, compression hip screw (CHS) or an intramedullary hip screw (IMHS). The underlying disease, postoperative complications, functional status and the level of activity in their daily routine were measured on the follow up examination.
RESULTS
There were 10 and 26 cases of neck and intertrochanteric fractures, repsectively, and all femur neck fracture patients were treated with a cemented bipolar endoprosthesis. In the intertrochanteric fractures, CHS and IMHS were used for the stable and unstable fractures according to the Evans classification, respectively. The Harris hip score measured one year after surgery was 84.1 points for the bipolar endoprosthesis group, 83.1 points for the compression hip screw group and 79.9 points for the intramedullary hip screw group. The dependency of daily living according to the K-ADL increased after surgery. The functional status measured using the Halpin's classification showed that 7 cases remained in the same grade, 21 cases stepped down one grade and the remaining 8 cases stepped down two grades. There was total of 3 deaths one year after surgery due to an aggravation of CHF in 2 cases and pneumonia in one case.
CONCLUSION
Hip fractures in patients more than 80 years of age have many complications. However, aggressive surgery is a reasonable treatment.