Complications in Treating Hip Fractures in the Elderly

Understanding Medical Negligence in Hip Fractures

Hip fractures in the elderly are a significant public health concern, particularly in England and Wales, where the ageing population is increasing. A hip fracture can be life-altering for older adults, often leading to severe complications and a marked decline in quality of life. While surgery is the most common treatment, the recovery process is fraught with challenges that can result in long-term disability or, in the worst cases, death.

If you’re concerned about potential medical negligence in elderly care, click here to learn more about pursuing a claim.

The Challenges of Treating Hip Fractures in the Elderly

Hip fractures typically occur in elderly individuals due to a combination of factors like weakened bones (often from osteoporosis), reduced mobility, and an increased risk of falls. When an older adult sustains a hip fracture, timely surgical intervention is often necessary. However, even with surgery, several complications can arise, many of which are influenced by the patient’s age, pre-existing conditions, and overall health.

Key complications in treating hip fractures in the elderly include:

1. Delayed Mobility and Immobility: Post-operative recovery often involves a period of immobility, which can increase the risk of bedsores (pressure ulcers), blood clots, and pneumonia. Many elderly patients also find it difficult to regain full mobility, which affects their independence and increases the risk of further falls.
2. Infections: Infections at the surgical site or complications from conditions such as urinary tract infections or pneumonia are common in older patients due to their weakened immune systems.
3. Pre-existing Health Conditions: Many elderly patients have co-morbidities such as heart disease, diabetes, or respiratory conditions. These underlying issues complicate both the surgical procedure and post-operative recovery.
4. Cognitive Decline: Conditions like dementia or delirium can worsen after surgery, leading to confusion and difficulties in rehabilitation. Cognitive impairments can also affect the patient’s ability to follow post-operative care instructions, which can lead to complications.
5. Poor Bone Health: Osteoporosis, common in elderly patients, makes healing difficult, leading to slower recovery or even non-union of the fractured bone. In some cases, the bone may not heal properly, necessitating additional surgeries.
6. Medication Complications: Older adults often take multiple medications (polypharmacy), and this can lead to adverse drug reactions or difficulties in managing pain and infection post-surgery.

Mortality Rates Following Hip Fractures in England and Wales

Hip fractures are associated with high mortality rates among the elderly. The National Hip Fracture Database (NHFD)(2023) collects data on hip fractures and outcomes in England and Wales, and the statistics paint a concerning picture regarding the survival rates post-fracture.

• 30-day mortality rate: Around 6-10% of elderly patients die within 30 days of sustaining a hip fracture. This rate reflects the immediate risks associated with surgery and complications like infections, blood clots, or heart problems.
• One-year mortality rate: The one-year mortality rate for older adults following a hip fracture is approximately 20-30%. This elevated mortality rate is influenced by the high prevalence of underlying health conditions, reduced mobility, and complications during recovery.
• Hospital readmissions: A significant number of patients are readmitted to hospitals within months of surgery, often due to complications such as infections, poor rehabilitation outcomes, or the progression of underlying conditions.

These high mortality rates highlight the vulnerability of elderly patients with hip fractures, particularly those over the age of 85 or with multiple co-morbidities.

Reducing Risks and Preventing Medical Negligence in Hip Fracture Treatment

To reduce the risks associated with treating hip fractures in the elderly, it’s crucial that healthcare teams implement comprehensive care strategies:

1. Early Surgery: Guidelines recommend that elderly patients receive surgery within 36 hours of a hip fracture. Delayed surgery increases the risk of complications such as infections, pneumonia, and blood clots.
2. Multidisciplinary Care: The involvement of a multidisciplinary team, including surgeons, geriatricians, physiotherapists, and occupational therapists, can improve outcomes by addressing the patient’s full spectrum of health needs.
3. Post-operative Rehabilitation: Effective rehabilitation, including physical therapy, is essential to help elderly patients regain mobility and independence. Programs that focus on early mobilization reduce the risk of long-term immobility and its associated complications.
4. Bone Health Management: Osteoporosis screening and treatment are critical to improving bone health post-fracture and preventing further falls or fractures. Medications such as bisphosphonates or calcium supplements may be prescribed to strengthen bones.
5. Prevention of Falls: Preventing future falls is crucial in elderly patients. This can involve home modifications, balance and strength exercises, and the use of assistive devices like walking frames.

Pursuing a Medical Negligence Claim for Hip Fracture

Hip fractures in the elderly are not just an orthopaedic emergency but a medical crisis that can lead to significant morbidity and mortality. In England and Wales, the mortality rates following hip fractures are sobering, with many elderly patients succumbing to complications within a year of their injury. The challenge lies in not only treating the fracture but also addressing the underlying health issues that exacerbate recovery difficulties.

By providing comprehensive, multidisciplinary care and focusing on fall prevention, the risks associated with hip fractures can be mitigated. Families and caregivers play a critical role in ensuring that elderly loved ones receive the best possible care, including early intervention and support during rehabilitation.

If you or a loved one has been affected by the topics discussed in this blog post, then don’t hesitate to reach out to our team of Medical Negligence Solicitors who are experts in this area.