Association of cognitive status with mobility and functioning after femoral neck fracture surgery in elderly patients: differences between hemiarthroplasty and internal fixation
Abstract
Background: Comparison of outcomes betweentwo different operative treatments of femoralneck fracture – hemiarthroplasty (HA) and internal fixation (IF) – remains an open issue. Weperformed new analyses of data from a previously published study with the aim of investigating the influence of cognitive problems on mobility and functioning after such surgery and comparing it between groups treated with HA and IF. Methods:Sixty-six elderly patients were consecutively enrolled in a prospective non-randomised study. The two groups (HA and IF, each comprising 33 patients) were balanced regarding age, gender and activity before injury. Data were gathered on their walking ability (categorised, measured via walking distance, and assessed using Walking Ability Index – WAI), cognitive status (assessed using Mini Mental State Examination – MMSE) and independence in activities of daily living (categorised, and assessed using Functional Independence Measure – FIM). Results: The association with MMSE score on admission was higher in the IF group than in the HA group for all the analysed outcome measures, i.e., walking distance at discharge, ability to walk unassisted (with walking aids) at discharge, ability to walk outdoors after three months, inde -pendence in activities of daily living after three months, improvement in motor FIM subscore after three months and WAI score at discharge. Conclusions: Presence of cognitive problems adversely affects walking ability and functioning mainly in patients operatively treated with IF after femoral neck fracture, and not (or to a much lesser extent) in patients treated with HA. It is recommended to take this into account during surgical decision-making.Downloads
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.