Operative treatment of hip fracture in haemodialysed patients.

PURPOSE To study operative treatment and postoperative clinical outcomes of hip fracture in haemodialysed patients. METHODS In 12 patients (8 men and 4 women) undergoing haemodialysis, 14 hip fractures were treated. Of these, 8 hips were treated with bipolar hip arthroplasty, one hip with total hip arthroplasty, 4 hips with a compression hip screw, and one hip with a gamma nail. The mean duration of dialysis treatment until fracture was 7 years. During a mean postoperative follow-up period of 17 months (range, 1-44 months), the patients' renal condition, type of fracture, and level of activities of daily living before and after surgery were assessed. RESULTS Of the 7 patients who died during a mean follow-up period of 17 months, 2 died from myocardial infarction, 2 from sepsis, and one each from gastric cancer, pulmonary oedema, and liver failure. Five of the 8 patients with diabetic nephropathy died, whereas 6 of the 8 patients who underwent bipolar hip arthroplasty or total hip arthroplasty died. Most of the patients had declined level of activities of daily living postoperatively. CONCLUSION For haemodialysed patients with fractures, it is essential to select the most suitable operating method and to conduct vigilant management before and after the operation.