Abstract
This short-term follow-up of retrospective analysis of femoral neck fractures in 24 patients (1 man, 23 women, mean 92.8 years old) in 90 years and older was designed to compare such fractures in patients in their 90s with those in their 80s (1 man, 29 women, mean 85.0 years old) and in their 70s (8 men, 22 women, mean 75.4 years old). The patients 90 years and older were treated from 1991 to 1999, and the patients 80s and 70s were from 1996 to 1999. These samples were consecutive, and the patients treated conservatively treated were excluded. The walking ability of posttreatment was assessed at discharge from our hospital (mean admission was 52.7 days). They were treated by open reduction and internal fixation or implantation of femoral head prosthesis. The patients were divided into four groups according to walking ability and the authors assigned a rating scale consisting of four points to independent walking or with a cane group, three points to the walking by walker group, two points to the wheel chair group and one point to the non-ambulatory group. In the group 90 years and older, the walking ability before their injury was 3.6 points, in the 80 years and older group it was 3.2 points, and in the 70 years and older group it was 3.1 points. After the treatment, the walking ability in the patients 90 years and older was 3.1 points, in 80s was 2.6 points and in 70s was 2.6 points. The differences of walking abilities between before and after the treatment were not significant in each generation. In conclusion, the treatment of femoral neck fractures for patients 90 years and older could be performed with expected resulting walking ability to be comparable to that of patients in younger generations.
