Should we operate on nonagenarians with hip fractures?

Studies on fractured necks of femurs usually have a cut off point at the ag e of 85. However, in view of an ageing populace it seems reasonable to look at the nature of hip fractures in the nonagenarians. In previous studies m ortality and morbidity of 90-year-olds has been high. It has also been sugg ested that operating on the demented and institutionalised is not particula rly effective, A 4-year review of 164 nonagenarian patients with hip fractu res was therefore conducted at York district hospital. Access to the record s of 136 (83%) patients was obtained with limited admission and mortality d ata from a further 28. Mortality rates at six months were 43% (24% in hospi tal) increasing to 46% at one year. Sixty-two patients had some complicatio n of which 35 were dead within 6 months. Sixty-two per cent of patients ret urned to their pre admission residence. The mortality rates in this review are lower than in some previous studies and of those that survived 6 months 53% had no postoperative complications. It would therefore seem reasonable to operate on nonagenarians. (C) 1999 Elsevier Science Ltd. All rights res erved.