Comparison of outcomes between hip fracture patients with concurrent upper limb injuries and patients with an isolated hip fracture.

ABSTRACT

BACKGROUND: Concurrent upper limb injuries can occur with hip fractures, and its incidence and effect on outcomes are unclear. The objective of this study was to review the number and types of upper limb injuries sustained by patients with hip fractures, and investigate how acute hospital stay, rehabilitation and patient outcomes are affected. METHODS: A retrospective study was performed on 820 patients with traumatic fracture of the hip over the age of 50. We reviewed the patients with concurrent upper limb injuries and compared patient outcomes - including mortality, acute length of stay in the orthopaedic ward, rehabilitation outcomes and rehabilitation length of stay. RESULTS: Thirty-four patients (4.1%) with a hip fracture had a concurrent upper limb injury. Patients with and without concurrent upper limb injuries had similar acute length of stays on the orthopaedic ward (mean 5.2 versus 5.5 days, P = 0.4), and no significant difference in mortality rates at time of discharge (0% versus 3.8%, P = 0.4) and at 30 days (2.9% versus 9.1%, P = 0.2). However, they also required significantly longer rehabilitation (mean 34.6 versus 19.9 days, P = 0.009) even after other demographic factors including upper limb injury, older age and dementia were taken into consideration (multivariate linear model concurrent upper limb injury, P = 0.0003; older age, P = 0.05; dementia, P = 0.09). CONCLUSION: A concurrent upper limb injury is infrequent in the hip fracture population. Overall, these patients were previously higher functioning than the average hip fracture patient and required longer stays in inpatient rehabilitation than patients with isolated hip fractures.