Age defying: survival and recovery of centenarians after hip fracture. A 12 year follow up

It is believed that Centenarians constitute a growing age group in Western countries and thus their hip fracture incidence should also increase. The aim of our study was to analyse incidence of centenarian hip fractures and their outcomes at our institution.

A retrospective evaluation of centenarians with hip fractures admitted over a period of 12 years (2012 to 2024) was performed. The authors identified 30 patients (24 female (80%) and 6 male (20%)) who have sustained a hip fracture at the age of 100 years or more. 18 patients (86,7%) were treated operatively and 4 patients (13,3%) were treated nonoperatively. Operative treatment varied from osteosynthesis (18 patients; 60%), partial or total arthroplasty (6 patients; 20% and 2 patients; 6% respectively) as well one patient (3,3%) with osteosynthesis due to a periprosthetic fracture. Average patient age at the time of the injury was 101 years, 8 months and 4 days (37137 days).

Mortality rates for patients at 1, 3, 6, 12 and 24 months were 19,2%, 42,3%, 46,2%, 57,7% and 78,3% respectively. At the time of conduction of this study 3 of the patients were still alive.

In the group of operatively treated patients the mean time from injury to death was 1year and 2 months (3 patients died before discharge), compared to just 3,5 months in nonoperatively treated group (2 patients died before discharge)

We are aware of the limitations of small sample analysis, especially when discussing optimal treatment and expected outcome in a patient group as infrequent as centanarians.

According to our data the number of Centenarian patients with hip fractures is not increasing. In the period studied our institution treated 2,5 such patients per year. Apart from the year 2019 when 5 such patients were treated, the number of centenarians admitted remains constant. The authors stipulate that the incidence of centenarians with hip fractures will remain constant or even decline due to past demographic events.

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