About 70–75,000 hip fractures (proximal femoral fractures) occur annually in the UK. Hip fracture is the commonest reason for admission to an orthopaedic ward, and is usually a ‘fragility’
fracture caused by a fall affecting an older person with osteoporosis or osteopaenia (a lesser degree of bone reduction and weakness due to the same process as in osteoporosis). The average age of a person with hip fracture is 77 years. The annual cost of medical and social care for all the hip fracture cases in the UK amounts to about £2 billion. Demographic projections indicate
that the UK annual incidence will rise to 91,500 by 2015 and 101,000 in 2020, with an associated increase in annual expenditure that could reach £2.2 billion by 2020.
Mortality is high – about 10% of people with a hip fracture die within month, and about one third within 12 months. However, fewer than half of deaths are attributable to the fracture. This reflects the high prevalence of comorbidity in people with hip fractures; often the combination of fall and fracture brings to light underlying ill health. This presents major challenges for anaesthetic, surgical, postoperative and rehabilitative care.
Research indicates, early individualized home-based rehabilitation program improved mobility recovery after hip fracture over standard care. To be efficacious in reducing or reversing disability after hip fracture, rehabilitation needs to be individualized, include many components, be progressive, and span a sufficiently long period.
The home based rehabilitation reduced perceived difficulties in negotiating stairs. The mixture path model revealed that less difficulty in negotiating stairs at 6 and 12 months correlated with better functional balance at 3 and 6 months.
Multidisciplinary model involving Occupational therapist (OT) and Physiotherapist (PT) coordinated community rehabilitation had a positive effect on patients’ perceived participation in their rehabilitation and Activities of daily living (ADL) at home.
