Why half of older hip fracture victims never fully recover

A broken hip could permanently pull the rug out from under active people 65 years and older. In fact, one in two will not fully recover if they suffer a hip fracture, according to a University of California study.

The observational study, recently published in the Journal of General Internal Medicine, examined 733 older adults before and after fractures, which likely occurred from a fall. The researchers measured how well participants were able to independently bathe, dress, eat and go to the bathroom after the injury. They found that less than half  made a full recovery, and in people 85 and older, the recovery rate was even lower.

Gregory L. Primus, MD, an orthopedic surgeon at Advocate Trinity Hospital, says the study reinforces what he and his colleagues have battled for years.

“This is nothing new to the orthopedic community. We have been pushing for clear hospital pathways and protocols for addressing hip fractures,’’ says Dr. Primus.

He adds that other studies have also shown that the impact of hip fractures on an entire family can be greater than a patient who sustains a heart attack.

“After a hip fracture, oftentimes, patients who were once independent and lived alone have to be admitted to nursing homes or assisted living communities,” says Dr. Primus.

While study author Victoria Tang suggests families set realistic expectations for life after a fall, Dr. Primus says patients and hospitals can take steps to improve recovery and decrease one-year mortality rates.

He recommends patients:

• Seek routine evaluations and treatment for osteoporosis and gait abnormalities
• Maintain a home environment free of potentially hazardous obstacles such as loose rugs and long draperies

In addition, Dr. Primus recommends hospitals implement best practices that include the following:

• Admissions protocol
• Joint orthopedic and geriatric care
• Surgery within 36 hours
• Geriatric review within 72 hours
• Total rehabilitation
• Falls and osteoporosis assessments
• Pre/post cognitive assessment
• Date submission to hip fracture database