PURPOSE To evaluate the functional changes, postop delirium and complications after cemented bipolar hemiarthroplasty for the femur neck fractures in patients aged around ninety. MATERIALS AND METHODS Between May 1995 and April 2002, of the twenty seven patients, 17 who follow-up for at least one year were included in this study. Walking ability, activity of daily living, mental status, chronic illness, postoperative delirium and complications were evaluated retrospectively using Yoon's walking class, ADL scale, MMSE-K score, ASA classification, DSM IV respectively. RESULTS The walking ability was decreased to 2.4 from 3.3 tendency of reliance in ADL scale was increased to 8.3 from 4.5, MMSE-K score was decreased to 15.9 from 21.7. There was no significant change in status of chronic illness. Postoperative delirium occurred in eight (47%) cases and all of them recovered completely. complications included bladder problem in eleven (66%) cases, temporary respiratory distress in two (12%) cases, hip dislocation in two (12%) cases, infection in one (6%) case. Overall thirteen (78%) cases were able to walk with supports. CONCLUSION This study indicates that physicians treation femur neck fractures in patients aged around ninety must anticipate worsening of the functional changes more especially in regard to walking level, activity of daily living and mental status, little changes of chronic disease status, complete recovery of postop delirium and high complication rate
The significant risk to life associated with the hip fracture has long been recognized, and the reports of poor prognosis are well known with wide range of mortality rates. We retrospectively studied 164 patients(older than 60 years) who had a hip fracture to determine the effects of the age, treatment methods, pre-existing medical condition, operative delay after injury, type of fracture, and others on patient mortality.
The summarized results were as follows ; 1. One hundred twenty three patients survived and forty one patients died(overall mortality rate; 25.0%).
2. Twenty one patients died within one year(one-year mortality rate, 12.8%).
3. Mortality was related to age of patient at injury, ASA classification, absense or presence of operative treatment, operation-related complication, which were statistically ignificant (P<0.05).
4. The operative delay after injury did not influence mortality, but we think that it is not signifcant because this study was done retrospectively.
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