Journal of Musculoskeletal Trauma

Original Articles

Cognitive Impairment in Hip Fracture Patients without Underlying Neurologic Diseases: Risk Factors and Relationship to Early Functional Recovery: Preliminary Study: Jae Yong Park, Yong Beom Lee, Kun Tae Park, Je Hyun Yoo, Narei Hong; J Korean Fract Soc 2016;29(1):34-41. Published online January 31, 2016; DOI: https://doi.org/10.12671/jkfs.2016.29.1.34

Abstract PDF Supplementary Material: PURPOSE
The aim of this study is to examine the risk factors of cognitive impairment in elderly hip fracture patients with no underlying neurologic disease, and to determine its effect on functional recovery postoperatively.
MATERIALS AND METHODS
From August 2012 to August 2013, 39 patients older than 65 years of age, who underwent hip fracture surgery and were followed-up for a minimum of 1 year at Hallym University Sacred Heart Hospital, were enrolled. All patients were assessed using Korean version of Mini-Mental State Examination (MMSE-K) after admission. All patients were divided into cognitive normal group (MMSE-K> or =24) and cognitive impairment group (MMSE-K<24). WOMAC (Western Ontario and McMaster University) score and Harris hip score were used for assessment of functional recovery at 6-month follow-up.
RESULTS
Sixteen patients (41.0%) were classified as the cognitive impairment group. The number of underlying diseases was the only statistically different factor between the two groups. In the evaluation of functional outcome, the functional decline was less in the cognitive normal group. Risk factors for cognitive impairment in elderly hip fracture patients were old age, high body mass index, and the number of underlying diseases, particularly an endocrinologic disease like diabetes.
CONCLUSION
Cognitive impairment in elderly patients may have a negative effect on functional recovery after hip fracture surgery. Therefore, we recommend routine evaluation of cognitive function in elderly hip fracture patients even with no underlying neurologic disease.

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The Daily Life Functions of Elderly Peritrochanteric Fracture Patients after Surgical Treatment: Dae Moo Shim, Tae Kyun Kim, Jong Yun Kim, Duk Hwa Choi, Joung Suk Lee, Seong In Lee; J Korean Fract Soc 2012;25(1):8-12. Published online January 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.1.8

Abstract PDF: PURPOSE
Although most peritrochanteric fractures in old age necessitates surgical treatment, daily life functions are still impaired after discharge. We assessed the types of peritrochanteric fracture, risk factors, and functional recovery in elderly patients who were over 65 years old. We also tried to determine factors for recovery to daily life.
MATERIALS AND METHODS
From January 2006 to December 2007, among 61 patients who were over 65 years old with the possibility of 1 year follow-up, 50 patients were selected through interviews. After verifying age, sex, mode, types of fracture, and method, we analyzed daily living activities with a functional recovery index and estimated recovery of daily life functions after surgery, assuming a score increase if functional recovery was good.
RESULTS
The mean age was 75.8 years, and females (31 patients, 62%) exceeded males. Slipping (27 patients, 54%) was the most common cause of fracture, and the intertrochanteric femur fracture was the most common fracture type (34, 68%). The average functional recovery index decreased 16.24% compared with the pre-operation value, having a tendency to decrease more in old age and female patients. Subtrochanteric femur fracture showed a 17.6% decrease in functional recovery index among the fracture types.
CONCLUSION
In elderly patients over 65 years, the functional recovery index after peritrochanteric fracture decreased 16.24% on average compared with the preoperation state. The largest decrease was in basic life ability. The functional recovery index decreased more in old age, females, and subtrochanteric femur fracture, which indicates these factors influence functional recovery.

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Functional Evaluation of the r-nailing Treatment of Intertrochanteric Fracture Older than 60 years Old Patient: Hwan Duk Yang, Tae Kyun Kim, Young Jin Kim, Jin Young Park, Hyoung Joon Kim, Ji Wan Lee, Eun Young Kil; J Korean Fract Soc 2005;18(4):364-368. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.364

Abstract PDF: PURPOSE
To evaluate the functional status after Gamma nailing in inter-trochanteric fractures in elderly with functional recovery score (FRS).
MATERIALS AND METHODS
We reviewed 285 patients of intertrochanteric fracture treated by gamma nailing from January 1993 to May 2002 with follow up more than 3 years. We analized recovery of functional status concerned with sex, age, fracture pattern, functional recovery index.
RESULTS
The intertrochanteric fractures in elderly resulted in 15.8% loss of function after 3 years. The more functional loss was observed in female, the older age, and Boyd-Graffin type II fracture but, were not signifily related with functional loss except age.
CONCLUSION
We concluded that the age is the important factor to functional recovery to pre-injury status in elderly patients.

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