HIP FRACTURE, DIAGNOSIS, SURGICAL TREATMENT, REHABILITATION, THROMBOEMBOLIC PROPHYLAXIS, BISPHOSPHONATES, FALL PREVENTION
Keywords:
Hip fracture, diagnosis, surgical treatment, rehabilitation, thromboembolic prophylaxis, bisphosphonates, fall preventionAbstract
Introduction. Hip fractures represent a major challenge in orthopedic trauma due to their high morbidity and mortality, particularly among elderly individuals. Women account for approximately 80% of cases, with an average patient age of 80 years. Key risk factors include falls, decreased bone mineral density, reduced physical activity levels, and prolonged use of certain medications.
Methods. Clinical evaluation of hip fractures typically reveals groin pain and an inability to bear weight on the affected limb. In displaced fractures, physical examination often shows external rotation, abduction, and limb shortening. Standard diagnostic imaging consists of anteroposterior pelvic radiographs and cross-table lateral hip views. In cases where an occult fracture is suspected despite normal radiographic findings, magnetic resonance imaging (MRI) is recommended for further assessment.
Results. Surgical intervention remains the primary treatment for most hip fractures, with the choice of procedure determined by the consulting orthopedic surgeon. Common surgical approaches include osteosynthesis and hip arthroplasty. Preoperative prophylactic antibiotics, particularly targeting Staphylococcus aureus, are administered to reduce the risk of infections. Additionally, venous thromboembolism prophylaxis, preferably with low-molecular-weight heparin, is recommended.
Conclusion. Hip fractures pose a significant health concern, necessitating prompt diagnosis and a multidisciplinary treatment approach. A combination of surgical repair, prophylactic measures, structured rehabilitation, and fall prevention strategies is essential for improving patient survival rates and enhancing quality of life in this vulnerable population.
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Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Kammerlander C, Gosch M, Blauth M, et al. The effects of comorbidities on outcomes in patients with hip fractures. Eur J Trauma Emerg Surg. 2017;43(3):349-357.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
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Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
Lalmohamed A, Vestergaard P, de Boer A, et al. Risk of fracture after bariatric surgery in the United Kingdom: population based, retrospective cohort study. BMJ. 2015;350:h3324.
Bliuc D, Nguyen ND, Milch VE, et al. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2015;313(22):2221-2231.
Kanis JA, Cooper C, Rizzoli R, et al. Identification and management of patients at increased risk of osteoporotic fracture: outcomes of an ESCEO expert consensus meeting. Osteoporos Int. 2016;27(1):1-13.
Gosch M, Hoffmann-Weltin Y, Roth T, et al. Orthogeriatric care for patients with hip fractures: where are we now?. Eur J Trauma Emerg Surg. 2016;42(3):257-265.
Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
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Gjertsen JE, Baste V, Fevang JM, et al. Quality indicators for hip fracture care. A systematic review. Osteoporos Int. 2016;27(1):1-11.
Cummings SR, Cosman F, Eastell R, et al. Goal-directed treatment of osteoporosis in patients with a recent fracture: a randomized controlled trial. J Bone Miner Res. 2017;32(3):594-602.
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Holt G, Smith R, Duncan K, et al. Early surgery for patients with a fracture of the hip decreases 30-day and one-year mortality. Bone Joint J. 2015;97-B(1):104-108.
Neuburger J, Currie C, Wakeman R, et al. The impact of comorbidities on mortality after hip fracture surgery. Age Ageing. 2017;46(3):397-404.
Kammerlander C, Roth T, Friedman SM, et al. Orthogeriatric service—a literature review comparing different models. Osteoporos Int. 2017;28(3):637-646.
