MORTALITY AND MORBIDITY AFTER HIP FRACTURE

Abstract

Objective-To study the mortality and morbidity associated with proximal femoral fractures with reference to fracture type (intracapsular and extra-capsular). Design-Consecutive prospective study with 12 month follow ups. Setting-Two British trauma receiving centres. Patients-1000 consecutive acute proximal femoral fractures (fractured necks of femur) in 972 patients. Results-Significantly higher mortality at one year was seen in patients with extracapsular fractures (188/490; 38%) than in those with intracapsular fractures (147/510; 29%; p < 001). Greater morbidity was experienced during the study period by patients with extracapsular fractures, who were less mobile and less independent at the time oftheir injury. Conclusions-The rise in average age ofpresenta-tion with proximal femoral fracture is associated with a persistently high mortality (33%) and morbidity, greater in patients with an extracapsular fracture. Comparison with other studies, principally from outside Britain, is difficult, but despite advanc-ing standards of care the mortality and morbidity of femoral neck fractures remains high, placing an ever increasing burden on the health service.