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. 2012 Dec;470(12):3596-606.
doi: 10.1007/s11999-012-2419-z. Epub 2012 Jun 16.

Do concomitant fractures with hip fractures influence complication rate and functional outcome?

Benjamin Buecking  1 , Christina Wack, Ludwig Oberkircher, Steffen Ruchholtz, Daphne Eschbach
Affiliations

Do concomitant fractures with hip fractures influence complication rate and functional outcome?

Benjamin Buecking et al. Clin Orthop Relat Res. 2012 Dec.

Abstract

Background: Owing to the aging population, the incidence of hip fractures is increasing. While concomitant fractures are not uncommon, it is unclear how they influence subsequent function.

Questions/purposes: Therefore, we determined (1) the incidence, type and treatment of concomitant fractures accompanying hip fractures, (2) the length of hospital stay, (3) the impact of concomitant fractures on mortality and complication rate, and (4) patients' function.

Methods: We retrospectively reviewed 402 patients older than 60 years with hip fractures. We recorded the presence of concomitant fractures and their treatment. We analyzed the duration of hospital stays, in-hospital mortality, perioperative complications, and function. We recorded function with the Barthel Index, Harris hip score, and timed up and go test. For this study we followed patients 1 year.

Results: Twenty-two patients (5%) had concomitant fractures, the most frequent being proximal humeral fractures (n = 8) and distal radius fractures (n = 6). Patients without and with concomitant fractures had similar lengths of hospitalization (mean, 14 days; 95% CI, 13-15 days), in-hospital mortality (5% with concomitant fractures, 6% without concomitant fractures), and incidence of complications (41% versus 40%). Function at discharge and last followup were similar in both groups.

Conclusion: The most frequent concomitant fractures were typical osteoporotic fractures (radial and humeral fractures). Concomitant fractures did not influence length of hospitalization, in-hospital mortality, complication rate, and function. Hip fracture and comorbidities predicted the incidence of complications and patients' function.

Level of evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1A–B
Fig. 1A–B
The radiographs of the concomitant pelvic ring fracture on (A) admission and (B) after hip fracture surgery are shown.
Fig. 2A–B
Fig. 2A–B
(A) Preoperative and (B) postoperative radiographs of the concomitant glenoid fracture are shown.
Fig. 3A–C
Fig. 3A–C
The graph shows (A) the duration of hospitalization in days, (B) the in-hospital mortality, and (C) the incidence of complications in patients with and without concomitant fractures.
Fig. 4A–D
Fig. 4A–D
The mean (A) Barthel Index at discharge, (B) the difference between the Barthel Index at discharge and prefracture, (C) the Harris hip score at discharge, and (D) the required time for the timed up and go test at discharge are shown for patients with and without concomitant fractures.
Fig. 5A–D
Fig. 5A–D
The mean (A) Barthel Index at 12 months, (B) the Harris hip score at 12 months, (C) the required time for the timed up and go (TUG) test at 12 months, and (D) the difference between the Barthel Index at 12 months and prefracture are shown for patients with and without concomitant fractures.
See this image and copyright information in PMC

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