OPERATIVE TREATMENT OF HIP-FRACTURES IN PATIENTS WITH RENAL-FAILURE

The conditions of a hip fracture and renal failure cause particularly high mortality. Eight patients (average age, 63 years) who had operati ve treatment for nine hip fractures were studied retrospectively. Thre e had intertrochanteric fractures fixed with sliding compression screw s, and five had femoral neck fractures (bilateral in one patient): two nondisplaced femoral neck fractures were fixed with percutaneous scre ws, and four displaced femoral neck fractures were treated with arthro plasties in three and percutaneous screws in one. Operative treatment was done when the patient was in medically stable condition (average, 8 days). Full weightbearing was allowed on the injured limb after surg ery. Early morbidity analysis showed no wound infections, thromboembol ic events, or hemorrhagic complications. The first year mortality was three (38%), Late morbidity included one nonunion and one sliding scre w penetration. Total mortality at 6 years was seven (88%) patients, wi th an average postoperative survival time of 28 months, Preoperative a mbulation was preserved in five of seven (71%) patients. On the basis of this study, it appears that a team approach to operative management including nephrologist and surgeon helps to reduce short term complic ations and mortality and allows such patients to be mobilized and rega in ambulation.