Curative effect of surgery within 48 hours after hip fracture in elderly patients / 中华骨科杂志

ABSTRACT

Objective To compare the clinical effects of surgery within and over 48 hours for hip fractures in elderly pa?tients. Methods From May 2017 to April 2018, 47 patients over 75 years old with hip fracture were operated in our hospital and met with inclusion criteria. The patients were divided into two groups within 48?hour group and over 48?hour group according to study design. In the within 48?hour group, there were 22 patients including 5 males and 17 females, aged from 76 to 97 years, with an average age of 83.6±5.0 years, and there were 10 femoral neck fractures (3 total hip arthroplasty, 7 hemiarthroplasty) and 12 femoral intertrochanteric fractures (proximal femoral intramedullary nail fixation). There were 25 patients (7 males and 18 females) in the over 48?hour group, aged from 76 to 98 years, with an average age of 83.8±5.8 years, and there were 10 femoral neck frac?tures (2 total hip arthroplasty, 8 hemiarthroplasty) and 15 femoral intertrochanteric fractures (proximal femoral intramedullary nail fixation). At the end of the follow?up period, the clinical data of the two groups were compared. The differences in the length of stay, cost of stay (excluding implants), postoperative complications within 1 month, hip function score (Harris score) within 1 month and 3 months, and mortality within 3 months and at the end of follow?up were analyzed. Results Both groups were fol?lowed up for 12 to 24 months, with an average of 17.7 months. The hospitalization time (7.9±3.0 d), hospitalization expenses (16 627.5± 6 428.8 yuan), the incidence of early complications after operation (59.1% ) and Harris score (80.9 ± 8.6) in the within 48?hour group were significantly better than those in the over 48?hour group (12.3±4.1 d, 23 799.0±9 785.3 yuan, 88.0%, 71.1±9.2, respec?tively). At 3 months after operation, there was no significant difference in Harris score between the two groups (83.9±7.3 in within 48?hour group and 82.3±8.9 in over 48?hour group; t=0.668, P=0.507). Within 3 months, there was no death inwithin 48?hour group, but 2 in over 48?hour group; and 1 in within 48?hour group at the last follow?up. Conclusion Elderly patients with hip fracture benefit significantly from surgery within 48 hours after admission.