Surgical treatment options for hip fractures in elderly patients aged 80 years old and over: A report of 915 cases / 第二军医大学学报

ABSTRACT

Objective To analyze the clinical data of 915 elderly patients with hip fractures (≥ 80 years old) receiving surgical treatment in our department over the past 10 years, so as to summarize the surgical strategies of hip fractures in elderly patients. Methods We included 915 patients with hip fractures aged 80 years and over from Jun. 2007 to Jun. 2016. Based on preoperative preparation and evaluation, the general condition and underlying diseases of patients were adjusted individually during the perioperation, and then the suitable anesthesia methods and reasonable internal fixation were selected and the surgery was performed as soon as possible. Active early functional exercise, specialist nursing and health education were conducted after surgery. The waiting time for operation, operation time, hospital stays, bleeding volume, postoperative systemic and local complications and 1-year mortality were analyzed. Results The mean operation time of the 915 patients was (69.5±34.2) min (range 50-120 min), the mean bleeding volume was (278.3±56.8) mL (range 150-440 mL), and the mean hospital stay was (5.6±3.2) d (range 5-31 d). There were 210 cases having systemic and local complications, with 117 cases of systemic complications and 93 cases of local complications. Fourteen patients died, accounting for 1.5% (14/915) of the total. The patients were divided into 7 d group according to the waiting time for operation. Our results showed that the waiting time for operation was longer, the mortalities and incidences of complications of patients were higher, with a significant difference found between the 3 groups (P<0.05). Conclusion Active preoperative preparation and evaluation, right anesthesia methods, reasonable internal fixation according to the fracture site and type, adjusting general condition and underlying disease drug during the perioperation, early surgery, active specialist nursing, preoperative health education and individualized diagnosis can all contribute to the treatment of elderly patients with hip fractures, improving the clinical efficacy and reduce the complications effectively.