Trauma

International Perspectives

The Japanese Perspective
Takashi Matsushita MD, DMSc
Department of Orthopaedic Surgery, Teikyo University School of Medicine
August, 2006

Disability and mortality of hip fractures 1 year after initial visit in Japan A prognostic survey of 10,992 patients

It is a major problem that the worldwide numbers of patients who need long-term care after osteoporotic fractures has been increasing. As is well known, vertebral fractures are the most common fractures in the elderly patient with osteoporosis. However, hip fractures provide a more critical problem for elderly patients, because of the loss of mobility which can result in the decrease of activity of daily living (ADL) for the patient.

A prognostic survey of ADL was performed 1 year after the initial visit at a total of 158 core orthopaedic hospitals in Japan between January 1999 and December 2001. A total of 10,992 hip fractures were assessed in this study. The report revealed that 85.6% of femoral neck fractures and 88.2% of the trochanteric fractures were surgically treated; the mean duration from fracture to surgery was 3.1 days; the rate of patients who were able to walk without assistance was reduced from 50.9 % to 26.8%; the duration of hospital stay was 49.8 days; and the 1-year mortality rate for the entire patient population over the 3-year period was 10.1%. It was concluded that hip fracture patients show a decrease in the ADL score 1 year after the initial visit and the duration of hospitalization is longer in Japan compared to other countries, but the mortality rate is lower.

I think it is still a challenging issue to overcome a decrease of ADL score after hip fractures in the elderly patient, but this critical issue should be resolved in the second half of the Bone and Joint Decade.

The results of this survey have been published in the journal:
Sakamoto K. et al.: Report on the Japanese Orthopaedic Association’s 3-year project observing hip fractures at fixed-point hospitals, J Orthop Sci, 2006, 11: 127-134.