Is there a need for orthogeriatric unit in the Indian hospital setup for managing hip fractures?

Abstract

AIMS: The current orthopedic treatment of geriatric hip fracture is inadequate as per the British Orthopaedic Association guidelines and hence to know whether there is a need of orthogeriatric unit in the tertiary hospital setups in India for the management of hip fracture. METHODOLOGY: This is a retrospective cross-sectional study, held in tertiary care teaching hospital. The data of patients with age >60 years admitted with hip fracture of 2016–2017 were recorded from medical record section. Age, sex, type of fracture, total duration of admission, delay in surgery, and associated comorbidities were recorded. Patients who had undergone hip surgery electively for other hip or acetabular fracture were excluded from the study. OBSERVATION: There were a total of 81 cases of hip fracture, of which there were 39 males and 42 females. Seventy-one percent of patients were from the age group of 60–70 years. Maximum number of (54.3%), 44 Patients were having intertrochanteric fracture, followed by fracture of the neck of the femur (35 patients) and subtrochanteric fracture (7 patients). These patients were treated with bipolar hemiarthroplasty, total hip replacement, or with proximal femoral nail fixation or with dynamic hip screw fixation. Hypertension, diabetes mellitus, asthma, and hemiparesis were associated diseases. The maximum stay was 65 days, the minimum stay was 8 days, and the average stay was 13 days.The average delay between admission to surgery was 7 days, maximum of 24 days. We could not analyze the exact cause for delay due to lack of proper data in most of the cases. CONCLUSION (IMPACT OF STUDY): Hip fractures in the elderly in India are increasing and not getting the quality of care required. There is an urgent need to the implementation of orthogeriatric unit, and team approach is required to curtail the delay in treatment. This may lead to decrease in the cost of treatment, reduced postfracture morbidity, and mortality. Formation of hip fracture registry would also help us to analyze the present status of care for hip fractures in the elderly.