![]() ![]() Hip fractures among the elderly: causes, consequences and control. Marks R, Allegrante JP, Ronald MacKenzie C, Lane JM. Keywords: Hip Fracture, Operative Management, Surgical technique, Medical co-management, Geriatrics, Fragility fracture, Osteoporosis, Femoral neck fracture, Intertrochanteric hip fracture, Subtrochanteric hip fracture, Hemi Hip Arthroplasty, Total Hip Arthroplasty, Sliding hip screw, cannulated screw fixation, Cephalomedullary nail, Intramedullary nail Intramedullary nails remain the gold-standard and mainstay of treatment of subtrochanteric hip fractures.Ĭonclusions: A thorough understanding of the differences in operative management of geriatric hip fractures may help orthopedic surgeons optimize patient outcomes as well as minimize health care costs related to implant choice. Stable fracture patterns may be treated by either a sliding hip screw (SHS) or cephalomedullary nail (CMN), with no current difference in total associated cost. Choice of implant for treatment of intertrochanteric hip fractures is determined by fracture stability. The main factor in the decision to proceed with THA is the pre-injury functional level of the patient, though no clear consensus has been reached as to precise definitions of functionality or thresholds for chronologic age. Controversy continues regarding Total Hip Arthroplasty (THA) versus Hemi Hip Arthroplasty (HA). Internal fixation remains a viable form of fixation in particular patient subgroups and is often driven by fracture pattern. Femoral neck fractures are treated with either internal fixation or arthroplasty. ![]() Non-operative management is reserved only for those patients where the risk of anesthesia outweighs the benefit of operative intervention. Results: Proximal femur fractures are common orthopaedic injuries in the geriatric population, and are subcategorized into femoral neck, intertrochanteric and subtrochanteric hip fractures. Main outcome measurement: Review of evidence-based surgical techniques for specific hip fracture patterns. Objectives: Provide a framework for the surgical treatment of patients with proximal femur fractures. Hip Fracture, Operative Management, Surgical technique, Geriatrics, Fragility fracture, Osteoporosis, Femoral neck fracture, Intertrochanteric hip fracture, Subtrochanteric hip fracture, Hemi Hip Arthroplasty, Total Hip Arthroplasty, Sliding hip screw, cannulated screw fixation, Cephalomedullary nail, Intramedullary nail Abstract William Beaumont Army Medical Center and Texas Tech University Health Science Center ![]()
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