A new clinical pathway for patients with fractured neck of femur -The orthopaedics operate, the geriatricians manage the medical work-up

Each year 9000 persons undergo surgery for hip fractures in Norway. The epidemic of hip fractures is associated with high morbidity, mortality, disability and subsequent hospital and social costs as well as impairment of quality of life. Hip fracture pati ents tend to be old and above all characterised by frailty. Traditionally hip fracture surgery is performed and followed by care in orthopaedic departments. Additional rehabilitation within the hospital is sometimes providded by a geriatrician and a team of rehabilitation specialists. The present project will evaluate the effect of doing a comprehensive geriatric work-up on patients with hip fractures in a specially designed orthogeriatric unit. We intend to randomize about 400 patients admitted to the emergency department to receive this new and radical clinical pathway or to have tradional care in an orthopedic unit. To evaluate mobility by the Timed Up & Go test and residential status (primary outcomes) with sufficient statistical power conservativ e estimates indicate that 170 persons is needed in each group in this RCT. The enrolment period will be 12 months, and data collection according to the extended SAHFE protocol will take place during the index stay and at 1, 4 and 12 months after enrolmen t. This protocol will be supplemented by a number of tests evaluating functional impairment and limitations especially related to mobility, gait and balance, and QoL. Health economic variables will be collected as well. It is applied for fundig of resea rch assistance and the day-to-day running of the project, and a grant for one PhD student.