Abstract
Introduction & aims
Geriatric hip fractures are a challenging clinical problem throughout the world. Hip fracture services have been shown to shorten time to surgery, decrease the cost of admissions, and improve the outcomes. We instituted a geriatric hip fracture program for co management of these injuries by orthopedic and internal medicine teams at our hospital in India.
Method
From January 2010 till December 2011, 119 patients with a femoral neck fracture were treated with cemented modular hemiarthroplasty under this program using a cost-effective Indian implant. The cohort included 63 males and 56 females with a mean age of 70.7 years (range 55–98 years). Hypertension (n=42) and diabetes mellitus (n=29) were the most common co morbidities. The follow-up period ranged from 12 to 37 months with an average of 24 months.
Results
The surgery was performed within 24 hours of admission in 60.5% (n=72) patients. The use of anti platelet drugs was the most common reason for delay of surgery. The mean length of hospital stay was 10.4 days (range 3–24 days) with 77% (n=92) of patients discharged within 1 week of admission. On follow-up, good to excellent Harris hip scores were seen in 88% of patients with 76% of patients returning to the pre injury ambulatory status. The mortality rate was 6% at 6 months follow-up and 10.9% at 2 years.
Conclusions
Our study shows that a hip fracture program can be instituted in India. The program helped us in achieving the goal of early surgery, mobilization, and discharge from hospital with decreased mortality
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