The management of subcapital fractures in the elderly — with an emphasis on economic aspects

Abstract

About 86 000 hip fractures occur each year in the United Kingdom (Donaldson et al., 1990) and approximately half are intracapsular (Singer et al., 1994). Mortality is 5—10% after 1 month and one third of patients will have died by 1 year (Johnell et al., 1992; French et al., 1995, 2006). The total estimated cost to society is almost £726 million per annum with over half of the cost attributed to social care of patients recovering from a broken hip as more than 10% of survivors will be unable to return to their previous residence (Keene et al.,1993). Hip fractures account for approximately 20% of orthopaedic bed occupancies in the UK, and based on current population trends, the number of hip fractures may rise to 120 000 per annum by 2015 (Johnell et al., 1992). In this article the management of elderly patients with subcapital or intracapsular type fractures is described with an emphasis on economic aspects.