Registration of Complications in Operative Treatment of Proximal Femoral Fractures in the Elderly

Background:

Surgery of proximal femur fractures can give rise to a high rate of postoperative complications and morbidity. In order to evaluate the results of proximal femoral surgery and to improve treatment in the elderly, we performed a prospective study between 1996 and 1998, scoring complications according to a special system used at our institute.

Patients: 268 patients (220 women; 82%), mean age 81 years (range 24–97 years), underwent surgery for proximal femoral fractures during a 2-year period.

Results: 172 complications (64%) occurred in 116 patients. Complications included pressure score (13.4%), urinary tract infection (8.5%), problems due to implantation of the osteosynthesis (8.5%), pneumonia (7.8%), minor wound infection (4.9%), urine retention (3.3%), deep venous thrombosis (0.7%), and myocardial infarction (0.4%). Mean hospital stay was 31 days (range 3–196 days). During this time, eleven of 268 patients died (mortality 4.1%). An error in management was seen in 30% of all complications, and technical errors in 21%. In 49% the complications was due to the patient's general health.

Conclusions: Surgery for proximal femur fractures is accompanied by complications in many patients, and especially in the elderly. Indeed, the patients in our study were elderly, and their poor general health accounted for nearly half of the complications encountered. The registration of complications may lead to new management/surgical protocols to prevent such complications in the near future.