Hip-fracture in the elderly caused by a fall - etiology and rehabilitation

55 patients aged 65 years and older with a fracture of the proximal end of femur caused by a fall who have been admitted to the Medizinisch-Geriatrisc he Klinik Albertinen-Haus Hamburg for rehabilitation during the period of h alf a year took part in the study. Aim of che study was to describe the success of treatment as well as to pre vent. further falls by identifying the reason for their recent fall. Three defined moments are the basis of this analysis: admission and discharge of the Albertinen-Haus and a follow-up research four years later by interviewi ng their general practitioners. In addition the general physical condition and life surroundings prior to the fall have been evaluated by an anamnesti c questionnaire. The average age was 81.1 years. All but three had been living at home prior to the fall and 72 % could be discharged to their home after rehabilitatio n. Five patients died while still at hospital. The reason for falling has been classified into intrinsic and extrinsic fac tors. Twenty-six patients (47.3 %) toppled due to an extrinsic and 20 (36.4 %)due to an intrinsic cause. In nine cases (16.4 %) no reason could be iden tified. No correlation between the patient's age and the success of treatme nt was found. However, the fear to fall again bad a significant negative in fluence on the success of treatment. The inquiry of 45 patients four years later showed that 42.2 % were living at home and 31.1 % in a nursing home. Within the four years 26.7 % died; 93 .7 % of the surviving patients were able to walk.