Hip Fracture - Management

Management

Most hip fractures are treated by orthopedic surgery, which involves implanting an orthosis. The surgery is a major stress on the patient, particularly in the elderly. Pain is significant, forcing the patient to remain immobilized. Since prolonged immobilization can be more of a health risk than the surgery itself, post-op patients are encouraged to become mobile as soon as possible, often with the assistance of rehabilitation professionals such as occupational therapy and physical therapy (physiotherapy). Skeletal traction pending surgery is not supported by the evidence.

If operative treatment is refused or the risks of surgery are considered to be too high the main emphasis of treatment is on pain relief. Skeletal traction may be considered for long term treatment. Aggressive chest physiotherapy is needed to reduce the risk of pneumonia and skilled rehabilitation and nursing to avoid pressure sores and DVT/pulmonary embolism Most people will be bedbound for several months. Non-operative treatment is no longer an alternative in developed countries with modern health care.

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