ORTHOPEDIC OR GERIATRIC REHABILITATION OF HIP FRACTURE PATIENTS - A PROSPECTIVE, RANDOMIZED, CLINICALLY CONTROLLED-STUDY IN MALMO, SWEDEN

From November 1988 to December 1989, all hip fracture patients in the municipality of Malmo, excluding nursing-home patients and patients wh o were already hospitalized at the time of the fracture, were postoper atively randomized to rehabilitation at either the orthopedic or the g eriatric department in Malmo. The study, which comprised 371 patients, compared the following end points: primary mortality; destination at discharge; total first-year mortality; and the number of hip prosthese s during the first postoperative year. No significant differences were found between the two regimens. One year after the fracture, patients discharged to their previous living arrangements were invited to a co ntrol visit conducted by a physiotherapist; no significant differences between the two groups were found in walking ability, use of walking aids, ''walking speed'', or absence or presence of pain in the operate d hip. Patients in the orthopedic group spent fewer days in the hospit al, but had significantly move re-admissions, primarily due to orthope dic-related diagnoses (p=0.003). The men in the geriatric arm of the t rial were on the average 5.5 years older. The types of fracture were n ot evenly distributed between the two regimens. More patients treated at the geriatric department received technical aids, and more had adju stments made in their homes.