The purpose of this retrospective study was to evaluate mortality after surgical therapy in very elderly patients over 90 years of age with hip fractures. We included 41 patients (6 males and 35 females) with mean age of 93 years who were treated surgically for neck or trochanteric fractures of the femur. We investigated walking ability before injury and after surgery, survival rate, and physical status before surgery using the classification of the American Society of Anesthesiologists (ASA) . Before injury, 36 patients (87.8%) had been able to walk with or without assistive devices, but at 4 months after surgery only 15 patients (36.6%) were able to do so. Survival rate was 88.6% at 4 months and 75.6% at 1 year after surgery.
Seven patients who were classified as ASA class I before surgery were all alive at 1 year after surgery. There was a significant difference in walking ability after surgery between the survivors and non-survivors. We considered that preservation of walking activity after surgery was important for improving the survival rate of very elderly patients with fractures of the femoral neck or trochanter.
