UMEM Educational Pearls

Category: Orthopedics

Title: Hip Fractures

Keywords: hip fracture, transfusion, analgesia (PubMed Search)

Posted: 6/22/2024 by Brian Corwell, MD (Updated: 7/17/2024)
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Hip Fractures

Femoral neck and intertrochanteric fractures occur most commonly among patients aged 65 and over

Major risk factors for hip fractures include osteoporosis and falls.

Patients with a low body mass index (BMI <22) appear to be at higher risk 

Isolated trochanteric fractures occur more often in young active adults

In-hospital mortality rates are approximately 5% (range 1-10%)  

In addition to making the diagnosis and consulting orthopedic surgery, ED providers must remember to provide adequate analgesia as elderly patients are often under medicated. 

         -Up to 72% receive no prehospital analgesia.

Extracapsular fractures cause more pain than intracapsular fractures due to the greater degree of periosteal trauma. 

Poor pain control predisposes hip fracture patients to delirium

Retrospective studies indicate that patients at higher risk for significant bleeding have at least 2 of the following risk factors:

         Age over 75 years, initial Hgb below 12 g/dL and peri trochanteric fracture location.