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Incidence rates of hip fractures in Latin America continue to rise. These fractures are associated with factors such as health, education, and socioeconomic status. Although there are many well-developed public and private healthcare systems available, the quality and consistency in the management of patients with hip fractures varies substantially. This article provides a summary review of national hip fracture care guidelines in 4 of the largest countries in Latin America (Mexico, Colombia, Brazil, and Argentina), describing national guidelines, audits, standard treatment approaches in each country and regional policies; with the goal of understanding and comparing the different guidelines, identifying the main problems in each country, learning from the policies of the other countries, and developing improvement projects.

<p><strong>Introducción</strong></p><p><strong></strong>El número de reemplazos totales de rodilla (RTR) en pacientes jóvenes continua en aumento. La literatura muestra resultados contradictorios y la mayoría incluyen pacientes con Artritis Reumatoide (AR). El propósito de este estudio fue analizar un grupo de RTR en menores de 55 años, excluyendo pacientes con AR, evaluando la sobrevida protésica, las fallas radiológicas y sus resultados funcionales.</p><p><strong>Materiales y Métodos</strong></p><p><strong>S</strong>e analizaron retrospectivamente 53 RTR en 46 pacientes, con una edad promedio de 49 (26-54) años y un seguimiento promedio de 6,5 (2-15) años. Los diagnósticos preoperatorios correspondieron a 46 gonartrosis idiopáticas, 5 postraumáticas y 2 osteonecrosis.<strong> </strong>22 presentaban antecedentes de cirugías previas. Se utilizaron 49 implantes importados y 4 nacionales. Los resultados clínico-funcionales se objetivaron mediante Knee Society Score y WOMAC, mientras que para la evaluación radiológica se utilizo el sistema de la Knee Society.</p><p><strong>Resultados</strong></p><p><strong></strong>La puntuación funcional del KSS mejoró de 49,3 a 92,6 en promedio, mientras que la puntuación propia de rodilla paso de 46,8 a 91,4 puntos en el posoperatorio. La puntuación WOMAC en promedio fue de 2,3 para dolor, 2,6 para rigidez y 27,3 para la capacidad funcional. El 16% presento líneas de radiolúcidas &lt;1mm que no progresaron en el tiempo. Hubieron 3 infecciones que requirieron de una revisión en dos tiempos evolucionando favorablemente y 4 rigideces que fueron tratadas mediante movilización artrocópica. La sobrevida protésica fue del 94,34%.</p><p><strong>Conclusiones</strong></p><p><strong></strong>El RTR en pacientes &lt;55 años mostró ser un procedimiento confiable en lo que respecta a la mejora de la función, con una aceptable sobrevida protésica teniendo en cuenta los antecedentes quirúrgicos previos. No observamos fallas radiológicas al final del seguimiento.</p>

Background: Hip fractures have a significant impact on morbidity and mortality in the elderly. Aims: We retrospectively evaluated the predictive role of the Charlson Comorbidity Index (CCI) for 1-year mortality in elderly patients with unstable intertrochanteric hip fractures (ITHF) treated with bipolar hemiarthroplasty. The secondary objective was to identify other relationships, if any, between the variables recorded and mortality. Methods: We included 75-year-old patients with unstable ITHF treated with bipolar hemiarthroplasty. We recorded patient gender, age, Body Mass Index, pre-fracture walking ability (Parker Mobility score, modified Harris Hip Score), America Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), time to surgery, time to mobilization, hospital stay, and postoperative complications. Uniand multivariate logistic regression analysis were performed. Sensitivity and specificity were calculated using a ROC curve. Results: A total of 135 patients with a mean age of 87.34 ± 5.5 years were included. The overall 1-year mortality rate was 18.5%. The CCI (OR 1.64 CI 95% 1.21e2.23; p 0.00821) and postoperative complications (OR 3.5 CI 95% 1.19e10.23 p 0.0202) were identified as independent predictors of 1-year mortality in the univariate regression and confirmed in the multivariate regression. CCI sensitivity to predict 1-year mortality was 80%. Conclusion: CCI has shown acceptable sensitivity in the prediction of 1-year mortality in elderly patients with unstable ITHF treated with bipolar hemiarthroplasty. It is of utmost importance to prevent postoperative complications due to their significant impact on 1-year mortality.