Background: The incidence of hip fracture varies by age and sex; it is more common in older people. Hip fracture in elderly osteoporotic patients most often results from low-energy trauma such as falling down. Since fracture neck of femur prevalence increases exponentially with age, as population age and longevity increases worldwide, these injuries are likely to occur at accelerated rates. This is important because among those who sustain fracture neck of femur and survive, an increasing number continue to experience various degrees of subsequent disability including a high risk for falls and further injury likewise. The incidence of hip fractures is increasing and the annual number worldwide is estimated to rise from 1.7 million in 1990 to 6.3 million by the year 2050. This will be a major challenge to the health care system and society. Thus, the present study was carried out to Compare the clinico-epidemiological factors responsible for differential mortality among elderly patients after surgical intervention for fracture neck of femur. Methodology: An open cohort, prospective study, was conducted in patients with fractures neck of femur (age 60 years and above) presenting to the Department of Orthopaedics, Dr RPGMC Kangra at Tanda and undergoing surgical intervention. All cases presenting to the department and fulfilling the criteria were studied for a period of one year starting from the date of start of the study. Results: 57.1% (n = 486) of the patients were males while remaining 42.9% (n = 36) of the patients were females. 52.4% (n = 44) had fracture of right femur while remaining 47.6% (n = 40) patents had fracture of left femur. 63.1% (n = 53) of the patients underwent bipolar hemi-arthroplasty while 34.5% (n = 29) underwent total hip replacement (THR). CRIF with DHS and PTCS was done in 1 patient each. Out of 84 patients, 1 patient died within 9 months of surgery and total of 5 patients died in one year with a peri-operative mortality rate of 5.95%. Mean age of the patients who died, was comparable to the mean age of the patients who survived (76.2±10.28 vs. 71±7.0; p = 0.08). All the patients who died were females. Mean BMI of the patients who died, was comparable to the mean BMI of the patients who survived (22.48±1.74 vs. 22.32±1.97; p = 0.325). 20% of died patients had grade 3 Singh’s Index, 20% had grade 2, 20% had grade 6 and 40% had grade 1 Singh’s Index. Singh’s index was comparable between both groups (p = 0.001). Conclusion: With the increase in population of elderly in Indian Subcontinent, a policy focused in injury management should take into consideration for peri and post operative mortality after fractures around the hip region.
Vatsyan et al. (Sat,) studied this question.
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