Mortality following hip fractures managed with hemiarthroplasty in the elderly in South Africa


  • A L J Du Toit University of the Free State
  • J F Van der Merwe University of the Free State


hip, fractures, elderly, mortality, hemiarthroplasty


Background: Limited studies are available documenting the demographics and mortality of hip fractures following surgery in South Africa and in Africa. The aim of this study was to evaluate short- and long-term mortality following displaced intracapsular femur neck fractures managed in the elderly with cemented hemiarthroplasty surgery at our institution.

Methods: Data was collected from 561 patients who were treated from 1 May 2001 to 30 April 2014. Mortality was confirmed with the National Population Register.

Results: The mean age was 77.96 years (SD=9.76) with more female (69.2%) compared to male (30.8%) patients. Male patients presented at a younger age (mean=74.6) than female patients (mean=79.4; p < 0.0001). The incidence of the affected side was similar, with right-sided hip fractures (49%) almost equalling left-sided hip fractures (51%). The overall cumulative all-cause mortality rates for patients were: 12.5% 30 days post-surgery, 22.7% 90 days post-surgery, 27.9% six months post-surgery and 34.3% one year post-surgery, respectively.

Conclusion: The results from this study showed a high mortality rate in comparison to international studies. Future research is required to identify risk factors associated with early mortality following hip fractures and this might help improving outcomes in our elderly patient population.

Level of evidence: Level 4

Author Biographies

A L J Du Toit, University of the Free State

MBChB(UFS), FC Orth (SA), MMed(Orth)(UFS); Registrar, Department of Orthopaedic Surgery, University of the Free State

J F Van der Merwe, University of the Free State

MBChB(US), MMed(Orth)(UFS); Head of Arthroplasty Unit, Department of Orthopaedic Surgery, University of the Free State