Hemiarthroplasty for displaced femoral neck fracture: good clinical outcome but uneven distribution of occupational therapy

Abstract

Purpose. To assess rehabilitation, type of follow-up visits and outcome after bipolar hemiarthroplasty for femoral neck fracture.

Method. Two hundred thirty-six consecutive patients with femoral neck fractures treated with hemiarthroplasty were followed for 30 months.

Results. One hundred sixty-eight (71%%) were women, 175 (74%%) over 80 years old and 53 (22%%) were demented. Of 150 patients with available 3-month data, 7 patients (5%%) had not regained their walking ability. Seventy (47%%) were pain-free and 112 (75%%) were back in their original habitat. A hip-related complication leading to a contact with the orthopaedic department occurred in 20 of all patients (8%%), and 7 (3%%) of these underwent a revision surgery. One hundred eighty-seven patients (79%%) received occupational therapy (OT). Demented patients received OT more seldom (p  <  0.001), as did patients aged 90 and older (p  ==  0.049).

Conclusion. Due to the low rate of orthopaedic complications, these patients are now referred to their general practitioners, without any further follow-up at the orthopaedic department. Rehabilitation efforts are unevenly distributed. The need of increased rehabilitation efforts for demented or ‘old old’ patients is discussed.

Keywords:

• Hip fracture
• rehabilitation
• occupational therapy
• reoperation, clinical outcome
• senile dementia