Abstract
Hip fractures are very common in the elderly and most of them are treated operatively because of severe comorbidity. The purpose of this study was to evaluate retrospectively the prognosis of patients who were treated nonoperatively.
303 patients were treated for hip fractures at our institution between January 2001 and December 2003, of them 41 cases (13.5%) were treated nonoperatively (5 men and 36 women). The mean age of the patients was 87 years (range, 58-98 years). The average follow-up period was 11.9 months (range, 3 days-36 months).
The 41 patients were treated nonoperatively because of severe comorbidity (44%), severe gait disturbance before injury (17%), complications after admission (15%), dementia (15%), or wishes of the patient and their family (10%). Cardiovascular disease was the most common comorbid illness that contraindicated operative treatment of the fracture. The mean period until patients were allowed bed-to-chair transfer with assistance was 14.1 days (range, 2-40 days). None of the 41 patients could walk at final observation, although most of them could move in a wheelchair. The rate of mortality was 12% at 3 months, 32% at 6 months, and 39% at 12 months. There was a significant difference in mortality between patients who could sit on a chair by two weeks (30%) and those who could not (62%).
