Journal Article

Postoperative outcomes in patients operated for extra- and intracapsular hip fractures – a secondary analysis of two randomized controlled trials

Johnsen, Lars Gunnar, Frihagen, Frede, Saltvedt, Ingvild, Wyller, Torgeir Bruun, Djuv, Ane, Taraldsen, Kristin, Watne, Leiv Otto, Paulsen, Aksel, Dakhil, Shams, Helbostad, Jorunn L.

2025

Overview

Background Hip fractures are among the most common and serious injuries in older adults. There has been a perception that extracapsular hip fractures have worse outcome than intracapsular hip fractures. We aimed to examine postoperative outcomes in patients operated for extra- and intracapsular hip fractures. Methods This is a secondary analysis of data from two randomized controlled trials evaluating the effect of orthogeriatric care. Bivariate analyses were conducted, comparing patients with extracapsular fracture to patients with intracapsular fracture. Mortality, length of hospital stay (LOS), new nursing home admissions, operative data and measures of functional and cognitive performance were assessed as endpoints. Results The primary analysis included 711 patients; 283 patients had an extracapsular fracture and 428 an intracapsular fracture. At four months follow-up, the intracapsular fracture group had significantly better Short Physical Performance Battery (SPPB) (5.0 vs. 4.0, p  = 0.007), personal Activities of Daily Living (p-ADL) (17.0 vs. 16.0, p  = 0.007) and instrumental ADL (i-ADL) (32.5 vs. 28.0, p  = 0.049). There were no statistically significant differences between the groups at 12 months. Conclusions Patients with an extracapsular fracture had worse mobility and ADL levels four months postoperatively, but there were no clinically relevant differences at 12 months postoperatively.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Activities of Daily Living / Aged / Aged, 80 and over / Anesthesia / Bone surgery / Care and treatment / Clinical trials / Cognitive ability / Comorbidity / Dementia / Diagnosis / Epidemiology / Extracapsular hip fracture / Female / Follow-Up Studies / Fractures / Gait / Geriatrics / Health aspects / Hip / Hip fracture / Hip Fractures - mortality / Hip Fractures - surgery / Hip joint / Humans / Internal Medicine / Intracapsular hip fracture / Joint surgery / Length of stay / Length of Stay - statistics & numerical data / Male / Medicine / Medicine & Public Health / Mortality / Nursing homes / Orthopedics / Patient admissions / Patients / Postoperative period / Proximal femoral hip fracture / Questionnaires / Randomized Controlled Trials as Topic / Recovery of Function / Rehabilitation / Rheumatology / Sports Medicine / Statistical analysis / Surgical outcomes / Treatment Outcome