Timing of treatment for fracture neck of femur in elderly patients a short term functional outcome study

Abstract

Background: Femoral neck fractures are disabling injuries common in the elderly population, often resulting from minor falls. These fractures are frequently operated on and associated with high postoperative fatality rates. The impact of surgical timing on functional outcomes remains unclear, though earlier interventions are suggested to improve prognosis and quality of life. Aim of the study: to investigate the relation between the time of surgery (Whether early, intermediate or late) and the functional outcome in elderly patients presented with fracture of femoral neck treated by Total hip replacement. Method: This prospective comparative case series study investigates the relationship between surgical timing and functional outcomes in 25 elderly patients with femoral neck fractures treated by total hip replacement. Patients were divided into three groups based on the time to surgery: Group A (Within 48 hours, n=7), Group B (48 hours to 7 days, n=15), and Group C (>7 days, n=3). Functional outcomes were assessed using the Harris Hip Score (HHS) at 1, 3, and 6 months postoperatively. Results: At 1 month, no significant difference in HHS was observed between groups (P=0.136). However, at 3 and 6 months, HHS was significantly lower in the >7 days group compared to the other groups (P=0.001). Delayed surgery (>7 days) was also significantly associated with pressure sore development (66.7%, P=0.044). Gender differences were minimal, but males had a significantly higher HHS at 6 months (P=0.029). Conclusion: The study concludes that early surgical intervention (Within 48 hours) leads to better postoperative mobility, pain relief, and reduced pressure sore incidence. Prompt management of femoral neck fractures is crucial to optimize recovery and quality of life in elderly patients.