title: Recovery after hip fractures: influence of bipolar hemiarthroplasty on physical disability and social dependency in the elderly.
abstract: Surgical treatment of femoral neck fractures is associated with a significant impact on quality of life. The aim of this study was to determine the long-term influence of displaced femoral neck fractures treated by bipolar hemiarthroplasty on the activities of daily living, quality of life and social dependency. We studied 487 geriatric patients treated in the years 1989 to 2003. At the beginning of follow-up in 2004, 166 patients were alive and evaluation was carried out on 145 patients (87.3%) at 91.3 (14 - 244) months postoperatively by a standardized questionnaire. All enrolled patients had been treated with cemented bipolar hemiarthroplasty for a displaced femoral neck fracture. Patients were evaluated concerning their average pre- and postoperative ability to walk, the need for assisting devices, type of residency and the SF-12® Score. Femoral neck fracture and hemiarthroplasty had a significant influence on all recorded aspects of quality of life. Even though almost two thirds of the patients needed assisting devices to walk after surgery, about two thirds returned to their original type of accommodation and the majority reached their original degree of mobility. Compared to a normal population no significant impact was observed on the quality of life measured by the SF-12® score. We consider bipolar hemiarthroplasty an effective treatment option for displaced femoral neck fractures in geriatric patients. Most patients returned to their original type of accommodation and level of mobility, even though the majority required a number of assisting devices to do so.
authors.affiliation: Department of Trauma and Handsurgery, Heinrich Heine University Hospital Duesseldorf, Duesseldorf, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Schneppendahl
authors.forename: Marcel
authors.initials: M
authors.lastname: Betsch
authors.forename: Vanco
authors.initials: V
authors.lastname: Petrov
authors.forename: Friedrich
authors.initials: F
authors.lastname: Böttner
authors.forename: Simon
authors.initials: S
authors.lastname: Thelen
authors.forename: Jan-Peter
authors.initials: JP
authors.lastname: Grassmann
authors.forename: Mohssen
authors.initials: M
authors.lastname: Hakimi
authors.forename: Joachim
authors.initials: J
authors.lastname: Windolf
authors.forename: Michael
authors.initials: M
authors.lastname: Wild
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000379:methods*; D017760:Bone Malalignment; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005265:Femoral Neck Fractures / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D004204:Joint Dislocations / Q000503:physiopathology / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012919:Social Behavior; D016138:Walking