Operative Treatment of Hip Fracture in Haemodialysed Patients

• Published in: Journal of orthopaedic surgery (Hong Kong) 2004-12, Vol.12 (2), p.158-163
• Main Authors: Sano, K, Ito, K, Inahata, Y, Ueno, T, Kou, A, Kimura, T, Imakiire, A
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip; Female; Follow-Up Studies; Fracture Fixation, Internal; Hip Fractures - surgery; Humans; Male; Middle Aged; Postoperative Complications; Renal Dialysis; Treatment Outcome
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/230949900401200204

Purpose. To study operative treatment and postoperative clinical outcomes of hip fracture in haemodialysed patients. Methods. In 12 patients (8 men and 4 women) undergoing haemodialysis, 14 hip fractures were treated. Of these, 8 hips were treated with bipolar hip arthroplasty, one hip with total hip arthroplasty, 4 hips with a compression hip screw, and one hip with a gamma nail. The mean duration of dialysis treatment until fracture was 7 years. During a mean postoperative follow-up period of 17 months (range, 1–44 months), the patients' renal condition, type of fracture, and level of activities of daily living before and after surgery were assessed. Results. Of the 7 patients who died during a mean follow-up period of 17 months, 2 died from myocardial infarction, 2 from sepsis, and one each from gastric cancer, pulmonary oedema, and liver failure. Five of the 8 patients with diabetic nephropathy died, whereas 6 of the 8 patients who underwent bipolar hip arthroplasty or total hip arthroplasty died. Most of the patients had declined level of activities of daily living postoperatively. Conclusion. For haemodialysed patients with fractures, it is essential to select the most suitable operating method and to conduct vigilant management before and after the operation.