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Not All Hip Fractures are Alike

Posted on: 10/11/2004
Not all hip fractures are alike. How you fare after a hip fracture depends on the type of fracture you have. Your health before the break is even more important. These are the results of a recent study of 537 patients.

Four different kinds of hip fractures were studied. All patients were older than 50 and had a fracture of the femur (the thighbone). The break was either in the femoral neck or at the intertrochanteric line.

The femoral neck is a bridge of bone between the end of the bone and the round ball off to the side that fits into the hip socket. The intertrochanteric line is at the base of the neck and sits between two bony bumps on the femur.

The fractures were both stable and unstable. An unstable fracture is more likely to collapse or break further. Some fractures were impacted, meaning that the two ends of the bone were pushed into each other. All patients in the study had surgery to repair or replace the hip. Some had screws put in to hold the bones together. Other patients got a new hip joint.

Before and after treatment each patient answered questions to measure function. The authors reported in detail common patient characteristics linked to each type of hip fracture. Blood loss, time in the operating room, and complications were also compared. Death occurred at an equal rate, regardless of the type of fracture.

The researchers in this study set out to describe differences in function and number of deaths after hip fracture. As expected, they found that death was linked to poor health and low function before the fracture. Patients with unstable fractures had the worst trouble with mobility six months later.

Knowing what happens to patients after each type of fracture may help doctors plan the best treatment for each patient. The best outcome still depends on patients' preinjury health and activity level.

Roger Cornwall, MD, et al. Functional Outcomes and Mortality Vary Among Different Types of Hip Fractures. In Clinical Orthopaedics and Related Research. August 2004. Vol. 425. Pp. 64-71.

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