Recent advances in the treatment of hip fractures in the elderly

Abstract

The treatment of hip fractures in the elderly represents a major public health priority and a source of ongoing debate among orthopaedic surgeons and anesthesiologists. Most of these injuries are treated with surgery in an expedient fashion. From the surgical perspective, there are certain special considerations in this population including osteoporosis, pre-existing arthritis, age, activity level, and overall health that contribute to the type of surgical fixation performed. Open reduction and internal fixation versus arthroplasty remain the two major categories of treatment. While the indications and treatment algorithms still remain controversial, the overall goal for these patients is early mobilization and prevention of morbidity and mortality. The use of preoperative, regional anesthesia has aided in this effort. The purpose of this review article is to examine the various treatment modalities for hip fractures in the elderly and discuss the most recent evidence in the face of a rapidly aging population.

Hip Fracture in the Elderly

“…20,21 Nonoperative treatment is associated with a high rate of secondary displacement and increased mortality and medical complications related to bed rest such as pneumonia, urinary tract infection, and deep vein thrombosis (DVT). Therefore, nonoperative treatment is not a recommended option for medically fit patients.…”

“…Therefore, nonoperative treatment is not a recommended option for medically fit patients. 20,22 It might be indicated in patients who are too ill to undergo any type of anesthesia with a terminal illness with a life expectancy that is too short to benefit from surgery. A recent retrospective study compared medically unfit patients who were treated nonoperatively to surgically treated patients and showed no significant difference in mortality or mobility.…”

Double reverse traction repositor versus traction table for the treatment of intertrochanteric femur fracture: A comparative Study

“…The unstable intertrochanteric fracture usually involves the trochanter minor and posteromedical cortex, even extends into subtrochanteric region [1]. It is popular to manage unstable intertrochanteric fracture with closed reduction and cephalomedullary nailing [2].…”

Three Year Experience of Treating the Acetabular Fracture with Reconstruction Plate at Civil Hospital Karachi

“…Stable fixation in these complex fracture injuries permits early mobilization and prevent complications of recumbency like bed sores and deep vein thrombosis 12 . Open reduction and stable fixation is the standard treatment for these fractures that lessens the incidence of arthritis and give satisfactory outcomes 13 . Matta JM 1996 14 describe the radiological grading and nature of fracture diminishment in 1996.…”