Amer Al-Ani
Karolinska Institute, Sweden
Title: Good functional outcome but not regained health related quality of life in the majority of 20-69 years old patients with femoral neck fracture treated with internal fixation: A prospective 2-year follow-up study of 182 patients
Biography
Biography: Amer Al-Ani
Abstract
Background & Purpose: Prospective studies on patient related outcome in patient <70 with a femoral neck fracture (FNF) are few. We aimed to investigate functional outcome and health-related quality of life (HRQoL) in 20-69 years old patients with a FNF treated with internal fixation.
Patients & Methods: 182 patients, 20-69 years with a FNF treated with internal fixation were prospectively included in a multicenter study. Follow up included radiographic and clinical examination at 4, 12 and 24 months. Collected data were on hip function using Harris hip score (HHS), HRQoL (EQ-5D and SF-36), fracture healing and re-operations.
Results: At 24 months, HHS was good or excellent in 73% of the patients with displaced fractures and 85% of the patients with non-displaced fracture (p=0.15). Of the patients with displaced fracture (n=120), 23% had a non-union (NU) and 15% had an avascular necrosis (AVN) with a 28% re-operation rate. None of the patients with non-displaced fracture (n=50) had an NU, 12% had a radiographic AVN and 8% needed a re-operation. The mean EQ-5Dindex in patients with displaced fracture decreased from 0.81 to 0.59 at 4 months, 0.63 at 12 months and 0.65 at 24 months (p<0.001). The corresponding values for patients with non-displaced fracture were 0.88, 0.69, 0.75 and 0.74 respectively (p<0.001). The mean SF-36 total score in patients with displaced fracture decreased from 76 to 55 at 4 months, 63 at 12 months and 0.65 at 24 months (p<0.001). The corresponding values for patients with non-displaced fracture were 80, 67, 74 and 0.76 respectively (p<0.001).
Interpretation: Three-quarters of the patients with displaced femoral neck fracture were healed after one operation and reported good or excellent functional outcome at 24 months. However, they did not regain their pre-fracture level of HRQoL.