Effect of pre-fracture mobility on the early post-operative functional outcome in elderly patients with a hip fracture

S Adam,D Maleka,L Godlwana

doi:10.4102/sajp.v69i3.28

Abstract

Background: Hip fractures are among the most commoncauses of disability and hospitalisation in the elderly. There are no studies inSouth Africa that determine the effect of pre-fracture functional mobility onearly post-operative functional outcome in elderly patients with a hip fracture.Aim: The aim of this study was to determine the effect of pre-fracture functionalmobility on early post-operative functional outcome in elderly patients with ahip fracture.Methodology: A prospective pre-test post-test observational study designwas done. Assessments were conducted pre-operatively, at discharge and sixweeks post discharge at two public hospitals in Johannesburg, South Africa. Thepre-fracture functional mobility of the participants was determined using theNew Mobility Score (NMS) pre-operatively. At discharge and at six weeks post discharge the participants post-operative functionallevel was assessed using the Elderly Mobility Scale (EMS) and the Lower Extremity Functional Scale (LEFS).Results: More than two thirds of participants were independently mobile prior to the fracture. Pre-fracture functional mobilityis a strong determinant of early post operative functional outcome in elderly patients with a hip fracture(β = 1.39, p = 0.0001).Conclusion: Independent pre-fracture mobility predicts better early post-operative functional outcomes in the elderly.

Highlights

Hip fractures are among the most common causes of disability and hospi talisation in the elderly and result in significant morbidity and mortality (Williams et al, 2004)
Patientsover the age of 60 years with a first time unilateral hip fracture were consecutively sampled from the orthopaedic wards of two public health care hospitals in Johannesburg, South Africa
Of the 90 participants recruited for the study at baseline, n=50 (69.4%) par ticipants were female and n=22 (30.6%) were male

Summary

Introduction

Hip fractures are among the most common causes of disability and hospi talisation in the elderly and result in significant morbidity and mortality (Williams et al, 2004). Determining the influencing factors on early postoperative functional outcome in elderly patients with a hip fracture in a selected public health setting in South Africa will identify those patients who are especially at risk of not regaining independence in basic mobility. Exploration of this topic may lead to future studies on improving functional outcome for these high risk patients. There are no studies in South Africa that determine the effect of pre-fracture functional mobility on early post-operative functional outcome in elderly patients with a hip fracture. The pre-fracture functional mobility of the participants was determined using the

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