Orthopedic or geriatric rehabilitation of hip fracture patients: a prospective, randomized, clinically controlled study in Malmö, Sweden

Abstract

From November 1988 to December 1989, all hip fracture patients in the municipality of Malmö, excluding nursing-home patients and patients who were already hospitalized at the time of the fracture, were postoperatively randomized to rehabilitation at either the orthopedic or the geriatric department in Malmö. The study, which comprised 371 patients, compared the following end points: primary mortality; destination at discharge; total first-year mortality; and the number of hip protheses during the first postoperative year. No significant differences were found between the two regimens. One year after the fracture, patients discharged to their previous living arrangements were invited to a control visit conducted by a physiotherapist; no significant differences between the two groups were found in walking ability, use of walking aids, "walking speed", or absence or presence of pain in the operated hip. Patients in the orthopedic group spent fewer days in the hospital, but had significantly more re-admissions, primarily due to orthopedic-related diagnoses (p = 0.003). The men in the geriatric arm of the trial were on the average 5.5 years older. The types of fracture were not evenly distributed between the two regimens. More patients treated at the geriatric department received technical aids, and more had adjustments made in their homes.