Journal
JOURNAL OF ORTHOPAEDIC TRAUMA
Volume 23, Issue 1, Pages 39-44Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/BOT.0b013e318191f5e4
Keywords
trochanteric fracture; fracture fixation; elderly; treatment outcome; quality of life
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Funding
- Stockholm County Council Research Fund (EXPO 1999)
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Objective: The aim of this study was to report the long-term outcome for patients with stable trochanteric fractures, especially regarding the health-related quality of life (HRQoL). Design: A prospective cohort study with a 2-year follow-up. Setting: Four university hospitals. Patients: One hundred forty-eight consecutive patients with stable trochanteric fractures, that is, a 2-part fracture (J-M 1 and 2) according to the Jensen-Michaelsen classification, treated with a sliding hip screw. Main Outcome Measurements: Mortality rate, reoperation rate, pain at the hip, walking ability, activities of daily living (ADL) function, and HRQoL assessed with the EuroQol-5D (EQ-5D(index) score). Results: The 2-year mortality rate was 29%. The reoperation rate was 3%. At the final follow-up, 81% of the patients reported no or only limited pain at the hip, 55% had regained their prefracture walking ability, and 66% their prefracture level of ADL function. The EQ-5D(index) score decreased from 0.69 before the fracture to 0.57 at 4 months, 0.59 at 12 months, and 0.66 at 24 months. Conclusions: Besides the expected mortality rate, the results of the study confirm a low reoperation rate and a good outcome regarding pain at the hip and only limited deterioration in HRQoL after a stable trochanteric fracture. However, a considerable number of the patients experienced deterioration in their walking ability and ADL function. The data on HRQoL obtained in this study can be used in future healthcare evaluations and to calculate quality-adjusted life years.
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