title: Musculoskeletal function and quality of life in elderly patients after a subtrochanteric femoral fracture treated with a cephalomedullary nail.
abstract: OBJECTIVE
  To report the musculoskeletal function and health-related quality of life in elderly patients after a subtrochanteric fracture treated with a single lag screw cephalomedullary nail.
  
  
  METHODS
  Prospective cohort study with a minimum 1-year follow-up.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Fifty-three patients, mean age 82 years (range, 61-94 years), with a subtrochanteric fracture of the femur.
  
  
  METHODS
  Fixation with a long Gamma cephalomedullary nail.
  
  
  METHODS
  Reoperation rate, musculoskeletal function (Short Musculoskeletal Function Assessment), and health-related quality of life (EuroQol-5D).
  
  
  RESULTS
  Six patients (11%) were reoperated on, five as a result of technical failures and one as a result of an ipsilateral fracture of the distal femur. The Short Musculoskeletal Function Assessment Dysfunction Index increased from 18 before the fracture to 46 at 4 months and 43 at 12 months. The corresponding values for the Short Musculoskeletal Function Assessment Bother Index were 10 before the fracture and 43 and 40 at 4 and 12 months (P < 0.001 between follow-ups and before fracture for both indices). The EuroQol-5Dindex score decreased from 0.85 to 0.49 at 4 months and remained at almost the same level at 12 months, 0.52 (P < 0.001 between follow-ups and before fracture).
  
  
  CONCLUSIONS
  A subtrochanteric fracture treated with a single lag screw cephalomedullary nail had a substantial negative impact on the patient's musculoskeletal function according to the Short Musculoskeletal Function Assessment as well as on the patient's health-related quality of life. However, the need for revision surgery was comparatively low.
authors.affiliation: Karolinska Institutet, Department of Clinical Science and Education, Section of Orthopaedics, Stockholm Söder Hospital, Stockholm, Sweden. ricard.miedel@sodersjukhuset.se
authors.forename: Ricard
authors.initials: R
authors.lastname: Miedel
authors.forename: Hans
authors.initials: H
authors.lastname: Törnkvist
authors.forename: Sari
authors.initials: S
authors.lastname: Ponzer
authors.forename: Anita
authors.initials: A
authors.lastname: Söderqvist
authors.forename: Jan
authors.initials: J
authors.lastname: Tidermark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D005260:Female; D005264:Femoral Fractures / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D016896:Treatment Outcome