Risk factors affecting the inability to regain pre-fracture mobility after hip fracture surgery in elderly patients

Abstract

Background: To evaluate the functional recovery at six months postoperatively in elderly patients with hip fractures and to determine the risks of not regaining to the pre-fracture mobility level.Materials and Method: In this retrospective observational cohort study, 281 patients over the age of 65 who underwent surgery for hip fracture were included in the study. The patients were divided into two groups (mobil without an aid and mobil with an aid) according to their pre-fracture level of mobility, and three groups according to their postoperative 6th month mobility level (mobil without an aid, mobil with an aid and immobile). In addition, motor-Functional Independence Measure (mFIM) scores were calculated to evaluate activities of daily living (ADL). Risk factors for not regain pre-fracture mobility and worsening of ADL were identified.Results: The rate of patients who could not regain their pre-fracture ADL after 6 months postoperatively was 34.1%. Patients with intertrochanteric fractures or those with an intraoperative proximal femoral nail (PFN) implanted were less likely to regain their pre-fracture mobility and ADL (p=0.006, p=0.005, respectively). The most important risk factors for not regain to pre-fracture mobility and worsening of ADL were advanced age, high ASA score, cardiovascular disease or malignancy among comorbidities, intertrochanteric fracture as fracture type, and PFN use as implant type.Conclusion: Advanced age, high ASA score, cardiovascular disease or malignancy among comorbidities, intertrochanteric fracture as fracture type, and use of PFN as implant type were the main risk factors for not regaining to pre-fracture mobility and ADL.