H. Galvard et Sm. Samuelsson, ORTHOPEDIC OR GERIATRIC REHABILITATION OF HIP FRACTURE PATIENTS - A PROSPECTIVE, RANDOMIZED, CLINICALLY CONTROLLED-STUDY IN MALMO, SWEDEN, Aging, 7(1), 1995, pp. 11-16
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.