Management and analysis of concurrent neck of femur and upper limb fractures: A retrospective single centre study

Objectives: To analyse rehabilitation outcomes of patients with both upper and lower limb fractures vs those with isolated hip fractures and determine if fixation improves management by looking at length of stay and overall outcomes.

Methods: Patient data reviewed from local trauma database revealing 287 patients with both upper and NOF fractures over the previous 10 years. Outcomes were compared to local ortho-geriatric data for 701 neck of femur fractures and national hip fracture data for 2020.

Outcomes: The results showed a lower average age for patients with concurrent fractures compared to the general hip fracture population. This was particularly true for those who had operations on both limbs. Although the average stay was around 4 days longer, the median stay was 2 days less than those with isolated NOF fractures. Most patients did not have an upper limb operation other than an MUA either in theatre or in the emergency department. A higher percentage of patients were able to go home but also a higher percentage required further rehabilitation after their inpatient stay. Mortality was marginally higher in all patients but lower in those that had both limbs fixed.

Discussion: The results show that outcomes are typically better when both fractures are fixed. This may be skewed however by younger patients being more likely to undergo fixation. Interestingly, MUAs do remarkably well vs fixation in the data set in all the categories with the exception of humeral shaft fractures.