Ambulatory function at three months is not influenced by the type of hip fracture. A comparative study between subcapital and pertrochanteric fractures

Abstract

Purpose: Hip fractures are a significant socio-sanitary problem, representing one of the most frequent cause of admission in Orthopaedic Surgery Departments. To date there are no studies comparing the outcomes in terms of ambulatory function depending on the type of hip fracture (subcapital vs pertrochanteric). Moreover, there is no clear consensus about the most useful assessment scales for this particular purpose; the novel Maximum Ambulatory Ability (MAA) score is presented. Methods: Cross-sectional observational study of ambispective nature. Participants were admitted after sustaining a hip fracture (pertrochanteric or subcapital) to the Orthopaedic Surgery Department of the Complejo Hospitalario Universitario Insular Materno Infantil and received surgical treatment, from September 2022, until the end of February 2023. Demographic and functional data was recorded at admission and after a follow-up period of 3 months. Results: The study included 70 subcapital and 72 pertrochanteric fractures with age and baseline function distribution. Functionality at 3-months according to the Functional Ambulatory (FAC) scale remained unchanged for 66.2 % of the patients, with no significant different among fracture types. According to the MMA scale, only 52.8 % of patients reached baseline function, with no differences between groups. Conclusion: Although a relevant proportion of patients lose ambulatory function after a hip fracture, at 3 months this is not influenced by fracture type. MAA scale revealed more sensitive than FAC in identifying ambulatory dependence for daily activities. The findings of this work add evidence to the recommendation of promoting the earliest possible functional recovery in hip fractured patients.

Keywords

• Hip fracture
• Function
• Outcomes
• Ambulation
• 3 months