Abstract:

Background: Hip fractures, a significant global source of disability and deaths, are escalating globally, particularly among the aging population due to an increase in life expectancy. Intertrochanteric fractures are commonest in literature, primarily caused by low energy trauma in the elderly and high energy trauma in the young, with 30-day mortality rates ranging from 10% to 13%. Assessing local hip fracture patterns, treatment options, and outcomes is crucial for identifying patients who may need therapeutic intervention.

Aim of the study: The study aimed at determining patterns, treatment options and outcomes of hip fractures among patients managed at Bugando Medical Centre (BMC).

Methods: An analytical ambi-directional study involving 98 patients aged 40 and above with hip fractures at BMC from July 2022 to April 2024, retrospective data collected from orthopedic wards inpatient registry completed by phone calls to the closest relative, and prospective part from same wards and outpatient clinics.

Results: 98 hip fracture participants met inclusion criteria, with a 2:1 M: F ratio and 73.1 years' mean age. Low energy injury contributed to 70.41% of fractures, with intertrochanteric fracture being the most common. The majority of hip fractures (63/68) were surgically managed, while 20.41% (20/98) refused hospital treatment and were discharged on request due to various reasons. Hip osteosynthesis was performed in 76.19% of fractures, whereas hip replacement was performed in 23.81% (15/63) of fractures. The average hospital stay was 14.34 days, with a 30days’ mortality of 19.39%. Female gender showed higher mortality odds than males (OR=3.8, P=0.009), with 11.22% experiencing clinical venous thromboembolism and 34.69% developing decubitus ulcers after a hip fracture. 30days after hip fracture treatment, 69.74% of patients had a modified Harris Hip Score of less than 70%, indicating a poor functional result, and it significantly decreased with increase in age (P=0.03)

Conclusion and Recommendation: Male contributed two times more hip fractures than females. The majority of hip fractures were due to low energy injury mechanism. The commonest pattern being intertrochanteric hip fractures. The study found higher 30-day mortality rates, clinical venous thromboembolism, and decubitus ulcers in hip fractures compared to other studies; urging further research, develop management protocols and increased theatre space to reduce hospital stay and related outcomes.