Title : PeriProsthetic Fractures (PPF) of the proximal femur – Defining the true patient impact
Abstract:
Background & Aim of the study: PeriProsthetic Fractures (PPF) pose an enormous physiological insult to patients. The post-injury recovery can be lengthy and turbulent. Portraying the magnitude of this can be challenging, and defining the expectations from recovery can prove hugely valuable.
Methods: A retrospective search of all patients presenting to a single tertiary centre with a PPF of the proximal femur around an arthroplasty stem managed surgically between 2012-2022 was performed. Data was collected regarding pre and post-injury mobility (at 1-year) as well as pre-injury and discharge residential status.
Results: 164 patients were identified. Of the 136 patients alive at 1-year, 42 (58.6%) saw a deterioration in their mobility, reflected by an increased mobility aid requirement. Of the 74 independently mobile pre-injury, 42 (56.8%) required a walking aid and 2 patients were unable to mobilise at all. Eight patients had insufficient information to analyse their mobility.
Twelve (7.3%) patients died before discharge and 21 had insufficient information to analyse residential status. Of the 131 remaining, 34 (26.0%) had an increased requirement for formal care, reflected by a requirement for a new care package or residential facility. Of the 119 living independently, 10 (8.4%) died before discharge, 18 (15.1%) required a formal care package and 12 (10.1%) required placement in a residential facility.
Conclusion: When counselling patients, more than half of previously independently mobile patients required walking aids at 1-year. A third of patients living independently pre-injury died or required formal care at discharge, including 1 in 10 requiring residential placement.
