Comparison of hip fracture mortality: 1946 to 1955 vs. 1982 to 1986.

: Hip fracture mortality was compared for patients treated surgically at the same hospital from 1946 to 1955 and from 1982 to 1986. Almost all hip fractures were treated surgically (98%) in the 1980 series, compared to the 1950 series (69%). The four-week surgical mortality rate decreased significantly from 13% to 4.2%. The internal fixation implants were different except for Knowles pins. The use of prostheses had increased four-fold from 4% to 17%. Most hip fracture patients were mobilized out of bed and earlier in the 1980 series, and most patients started physical therapy earlier. Possible factors contributing to this decrease in mortality include better medical management, better implants to allow rapid mobilization of the patient, emphasis on early physical therapy and advances in anesthesia.