Most patients aged 50 to 80 will be able to live and walk independently in 1 year after hip fracture, reports a study in the Journal of Orthopaedic Trauma. The journal is published in the Lippincott portfolio by Wolters Kluwer.
Even patients older than 80 are usually able to resume living independently – although they’re less likely to regain independent walking ability and may likely need some kind of walking aid, according to the study, led by Emil H. Schemitsch, MD, of University of Western Ontario.
“Identifying factors associated with living and walking independently following hip fracture may help surgeons better identify which patients are at risk and optimize care of patients with this injury,” they write, according to a media release from Wolters Kluwer.
The study included over 600 patients aged 50 or older who underwent surgery for fracture of the femoral neck.
Patients were drawn from the recently completed FAITH (Fixation using Alternative Implants for the Treatment of Hip fractures) randomized controlled trial. That study compared two types of bone screws (cancellous screws versus a sliding hip screw) for fracture repair in 1,079 patients from 81 clinical sites in the United States, Canada, Australia, the Netherlands, Norway, Germany, the United Kingdom, and India.
The new analysis included patients who were living and/or walking independently before they fractured their hip, and had 1-year follow-up data on whether they had returned to independent, non-institutionalized living and independent walking, without any type of walking aid. The goals of the study were to descriptively quantify patients’ changes in living status and use of walking aids over the 1 year after hip fracture and identify factors predicting a greater chance of returning to independent living and independent mobility, the release explains.
One year after hip fracture, 3% of patients aged 50 to 80 years at the time of surgery were living in some type of institution, as compared to 20% of patients older than 80. Of those who were walking independently before hip fracture, about 34% of 50- to 80-year-old patients required some type of walking aid, as did 69% of those in the over-80 group.
Age 50 to 80 was a strong predictor of returning to independent living and independent walking 1 year after hip fracture surgery. Patients with good fitness before surgery (ASA physical status class I) and current nonsmokers were also more likely to regain independent living and independent walking ability within 1 year after hip fracture.
Patients who were not using a walking aid before their hip fracture and those having “acceptable” hip implant placement were also more likely to return to independent living. Predictors of independent walking included living independently before fracture, having a non-displaced fracture, and not needing revision surgery, the release continues.
In addition to age, previous physical fitness, smoking, certain fracture characteristics, and undergoing revision surgery to the hip also affect the chances of regaining independence.
“Identifying factors associated with living and walking independently following a hip fracture may help the orthopaedic community better identify which patients are at risk for loss of independence and mobility following a hip fracture, and ultimately help to optimize the care of patients with this type of injury,” the researchers conclude, in the release.