Management Of Patients With Hip Fractures-References

References

Pdf Summary

This comprehensive reference list supports current guidelines (2023-2026) for managing hip fracture patients, addressing epidemiology, clinical care, and outcomes. Hip fractures are prevalent in older adults, with risk factors including age, osteoporosis, frailty, and use of fall-risk-increasing medications. Studies show substantial morbidity, mortality, disability, and healthcare costs associated with hip fractures globally, underscoring the importance of optimized management.<br /><br />Clinical management emphasizes multidisciplinary approaches, notably medical-orthopaedic comanagement and comprehensive geriatric assessment, which improve outcomes such as reduced mortality, complications, and delirium. Early surgical intervention—ideally within 24 hours—is linked to fewer postoperative complications and shorter hospital stays. Controversies exist around anesthesia type; recent trials show no definitive advantage of spinal versus general anesthesia for delirium risk. Preoperative risk assessment using cardiac and pulmonary risk calculators guides perioperative care.<br /><br />Surgical options include hemiarthroplasty or total hip arthroplasty for displaced femoral neck fractures, and nailing for intertrochanteric fractures, tailored by patient age and fracture type. Postoperative care involves venous thromboembolism (VTE) prophylaxis; evidence supports use of low-molecular-weight heparin or direct oral anticoagulants, with aspirin as an alternative in select patients. Attention to pressure ulcer prevention, pain management (including peripheral nerve blocks), and delirium prevention is critical for recovery.<br /><br />Secondary fracture prevention is essential, with osteoporosis diagnosis and treatment using bisphosphonates or zoledronic acid shown to reduce subsequent fractures and mortality. Timing of osteoporosis medication initiation post-surgery is studied for optimizing fracture healing and functional recovery. Vitamin D and calcium supplementation have mixed evidence for fracture prevention but remain part of care strategies.<br /><br />Finally, palliative care considerations are important for patients with advanced dementia or high frailty. Overall, these references collectively underscore a patient-centered, evidence-based, multidisciplinary approach to hip fracture management to improve survival, functional outcomes, and quality of life.

Keywords

hip fracture

older adults

osteoporosis

multidisciplinary management

early surgical intervention

hemiarthroplasty

venous thromboembolism prophylaxis

bisphosphonates

delirium prevention

palliative care