PROXIMAL FEMUR FRACTURES IN OLDER ADULTS: CHALLENGES AND OUTCOMES – A DESCRIPTIVE CROSS-SECTIONAL STUDY
Keywords:
hip fracture, elderly, geriatric patients, quality of life, nursing care, orthopedic surgery, comorbiditiesAbstract
Proximal femur fractures most commonly occur in older adults and represent a significant medical (orthopedic) and socio-economic problem. The incidence of hip fractures is increasing globally, primarily due to longer life expectancy. It is estimated that by 2050, the number of cases will reach 6.26 million annually. Numerous studies support the view that patients operated on within 24 hours of hospitalization have better outcomes in terms of complications and mortality compared to those operated on later. Fractures often result from "low-energy trauma," frequently due to falls from standing height. Globally, a hip fracture occurs every three seconds, with substantial human and socio-economic impact, including morbidity, mortality, and healthcare costs. For affected individuals, fractures often lead to loss of autonomy, decreased quality of life, and the need for third-party care. Objective: To analyze the incidence of hip fractures in elderly patients, the type and pattern of fracture, and the number of operative and conservative treatments. Study Design: Descriptive cross-sectional study. Participants and Methods: A total of 94 patients hospitalized for hip fractures over a 10-month period were included. Descriptive statistical analysis was performed. Results: Among the 94 hospitalized patients, 30 were male (mean age 82.8 years) and 64 were female (mean age 82.9 years). Femoral neck fractures were diagnosed in 49 patients (%), intertrochanteric fractures in 19 patients (%), and subtrochanteric fractures in 26 patients (%). The most commonly used surgical techniques were partial arthroplasty with implantation of a unipolar prosthesis (Austin Moore), followed by osteosynthesis with a Gamma Nail. Conclusion: Over 85% of patients with hip fractures are older than 65 years and have pre-existing comorbidities. Despite adequate and optimal treatment, age and comorbidities predispose these patients to poorer prognosis, higher morbidity, and mortality compared to the general population. Patients with hip fractures should ideally be operated on within 24 hours of hospital admission, unless acute medical conditions contraindicate surgery. If the medical condition can be corrected, surgery can be delayed up to 48 hours, but the waiting time should not exceed four days. In addition to clinical and radiological assessment, patients should undergo evaluation of general, physical, mental, and social functioning to obtain a more accurate picture of their overall condition. The SF-36 questionnaire, among others, is widely used in such studies and is recommended for clinical practice. Furthermore, assessing the general health status and quality of life of a healthy population is necessary to provide reference values.
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