• BACKGROUND
    • Hip fractures typically occur in geriatric patients representing an increasing medical as well as socioeconomic challenge.
  • PATIENTS AND METHODS
    • In order to reveal the influence of considerable comorbidities and the time of surgery in the treatment of geriatric hip fractures we analysed patients treated between 1993 and 2008 at a level I trauma centre.
  • RESULTS
    • 654 patients with isolated hip fractures were included. Surgical treatment was performed with osteosynthetic stabilisation in 55.5 % (n = 363) and with endoprosthetic implants in 44.5 % (n = 291). The presence of pulmonary, psychiatric and metabolic/endocrinological comorbidities resulted in delayed treatment. If an early surgical treatment was performed within the first 12 hours after hospital admission, long-term survival was significantly improved (p = 0.02). A regression analysis revealed a statistical trend towards an increased mortality of 0.2 % per hour delay after hospital admission. The presence of considerable comorbidities and surgical treatment with endoprosthetic implants (odds ratio 1.611) were proven as independent mortality factors.
  • CONCLUSION
    • The present study supports the guideline of early surgical treatment of geriatric hip fractures. Emphasising the incidence of in-hospital complications and the mortality after endoprosthetic treatment, osteosynthetic fracture stabilisation should be considered in the presence of considerable morbidity and pre-surgical immobilisation.