Quality of life related to fracture displacement among elderly patients with femoral neck fractures treated with internal fixation.
OBJECTIVE
To determine differences in outcome between undisplaced (Garden I and II) and displaced (Garden III and IV) femoral neck fractures in elderly patients treated with internal fixation.


METHODS
University hospital.


METHODS
Prospective clinical study.


METHODS
Ninety patients with an acute femoral neck fracture after a fall. The inclusion criteria were age older than sixty-five years, absence of severe cognitive dysfunction, independent living, and unhindered walking capability preoperatively. The mean follow-up was twenty-six months.


METHODS
The patients were treated with closed reduction and percutaneous internal fixation with two cannulated screws.


METHODS
Fracture healing complications, pain (visual analogue scale), walking capability, activities of daily living, and quality of life according to EuroQol.


RESULTS
The rate of fracture healing complications in displaced femoral neck fractures in patients available at the final follow-up was 36 percent compared with 7 percent in patients with undisplaced fractures. The quality of life, according to EuroQol, of patients with uneventfully healed fractures was significantly lower in patients with primarily displaced fractures (0.51) than in patients with undisplaced ones (0.76).


CONCLUSIONS
There was a major difference in outcome on comparing undisplaced and displaced femoral neck fractures in elderly patients treated with internal fixation. The rate of fracture healing complications in patients with undisplaced fractures was low, and patients with healed fractures regained their prefracture quality of life level. The rate of fracture healing complications and reoperations in patients with displaced fractures was high, and even in patients with uneventfully healed fractures, there was a substantial decrease in the quality of life.
Tidermark
Jan
J
Department of Orthopaedics, Stockholm Söder Hospital, Stockholm, Sweden.
Zethraeus
Niklas
N
Svensson
Olle
O
Törnkvist
Hans
H
Ponzer
Sari
S
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011336:Probability; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D018709:Statistics, Nonparametric; D016896:Treatment Outcome