PROSPECTIVE COMPARISON OF HIP FRACTURE TREATMENT - 856 CASES FOLLOWEDFOR 4 MONTHS IN THE NETHERLANDS AND SWEDEN

In a prospective multicenter study 1115 hip fracture patients were reg istered in Rotterdam (The Netherlands), Sundsvall and Lund (Sweden). T he patients had similar background parameters with a mean age of 78 ye ars, about half of them living alone and just above 80 percent coming from independent living. For cervical fracture, hemiarthroplasty was t he predominating treatment in Rotterdam (n 169), whereas osteosynthesi s was used in Sundsvall (screws n 135) and Lund (hook-pins n 148). The mean (median) hospitalization time was 32 (20) days in Rotterdam, 16 (12 ) days in Sundsvall, and 17 (10) days in Lund. Discharge to indepe ndent living varied from 53 percent in Lund to 72 percent in Sundsvall . Functional outcome (walking ability and ADL capacity) was at 4 month s similar in all groups, but at 2 weeks was lower in Rotterdam. Mortal ity at 2 weeks/1 month/4 months was in Rotterdam 4/9/20, in Sundsvall 2/4/13, and in Lund 0/3/10 percent. Trochanteric fractures were treate d by screwplate in Rotterdam (n 146) and Lund (n 78), and by Ender nai ls in Sundsvall (n 117). The mean (median) hospitalization time was in Rotterdam 39 (29) days, in Sundsvall 24 (15) days and in Lund 19 (11) days. Discharge to independent living varied from 41 percent in Lund to 57 percent in Sundsvall. Functional outcome was similar between the groups. Mortality at 2 weeks/1 month/4 months was in Rotterdam 2/6/14 , in Sundsvall 6/12/19 and in Lund 12/12/18 percent. Thus, our study h as shown that it is possible to perform a prospective multicenter stud y involving different European countries. The functional outcome after 4 months was very consistent between the centers studied, irrespectiv e of choices made concerning operation method and rehabilitation routi nes. However, a difference in mortality within these first postoperati ve months was found, which seems attributable to the operation procedu re.