hip fracture
Jump to navigation
Jump to search
[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102][103][104]
Introduction
Generally referring to fracture of the neck of the femur (45%). (Also see intertrochanteric (45%) & subtrochanteric fracture (10%))
Etiology
Relative risk involves the interplay of reduced bone mineral density & falls
- age (per 5 years) (1.4)
- maternal hip fracture (1.8)
- loss of height since 25 years (1.3)
- medications
- long-acting benzodiazepines (1.6)
- anticonvulsants (2.0)
- current caffeine use (1.2)
- proton pump inhibitor[14]
- antidepressants[33]
- high doses of both vit B6 & vit B12 associated with 50% higher risk[80]
- on feet < 4 hours/day (1.7)
- unable to rise from chair (1.7)
- poor visual depth perception (1.4)
- poor visual contrast sensitivity (1.2)
- resting pulse > 80 bpm
- Caucasian race[3]
- cognitive dysfunction[3]; dementia (RR=3)[67]
- female sex[3]
- history of falls[3]
- prior history of fracture[4]
- lower body weight[5]
- smoking[5]
- poor functional status[5]
- hyperhomocysteinemia (2-4)[8]
- stroke, risk increased in paretic limb[10]
- low serum 25-hydroxyvitamin D (post-menopausal women)[18]
- osteoporosis, low bone-mineral density
- falling from a standing position or less defines osteoporotic fracture[101]
- thyroid disease
- hyperthyroidism (both sexes)
- subclinical hypothyroidism (RR = 2.3) in men
- subclinical hyperthyroidism (RR = 3.3) in men
- subclinical thyroid disease does not appear to be a risk factor in women[22]
* see[45] for risk calculator
Epidemiology
- 250,000/year in patients > 65 years of age
- females
- 15% lifetime risk for 85 year caucasian woman
Clinical manifestations
- non-displaced fracture may present only with groin pain & reluctance to bear weight
- ability to walk & bear weight makes hip fracture unlikely
Diagnostic procedures
- preoperative testing recommended only for patients with:
- decompensated heart failure
- unstable angina
- significant cardiac arrhythmias
- severe valvular disease[28]
Radiology
- plain X-ray of hip* (imaging modality of choice)
- weight-bearing AP pelvis X-ray
- width of hip joint, qualitative bone density, sacroiliac joint
- both false positive & false negative X-rays not uncommon (12-14%)[21]
- MRI for suspected fracture NOT demonstrated by X-ray, evaluation of osteonecrosis, infection, tumor,intertrochanteric extension of greater trochanteric fracture[88]
- computed tomography with 79% sensitivity & 91% specificity vs MRI[88]
- bone scan when MRI not available
* X-ray of subtrochanteric fracture of femur (hip fracture)[99]
Complications
- highest mortality in 1st 4-6 months
- 30 day mortality 4-12%[53]
- mortality at 1 year, 14-16%
- higher mortality with:
- co-morbidities/cognitive deficits
- premorbid institutionalization
- male gender
- longer hospital stay[53]
- RR of mortality = 2.03 for hospital stay of >14 days
- higher in hospital mortality after surgery for hip fracture than elective total hip replacement (RR at least 6)[49]
- in hospital hip fracture with greater risk of institutionalization & death vs hip fracture in the community[103][104]
- avascular osteonecrosis
- increased risk of institutionalization
- deep vein thrombosis:
- most occur in 1st week
- incidence of 11% when surgery delayed > 24 hours[70]
- pulmonary complications, COPD is risk factor
- pneumonia
- difficulty weaning from ventilator
- urinary tract infection[11]
- heart failure[11]
- pressure ulcer
- constipation
- delirium
- risk factor for institutionalization & functional decline[58]
- duration of postoperative delirium is an independent risk factor for 6 month mortality[57]
- peripheral nerve injury
- joint or prosthesis infection
- fat embolism
* Late Complications:
- hip fracture non union
- heterotopic ossification
- loosening of fixation of prosthesis
Differential diagnosis
see hip pain
Management
(also see Garden classification)
- general
- pain management:
- ultrasound-guided lateral cutaneous femoral nerve block[99]
- morphine IV as needed
- consultation from orthopedic surgery to general medicine or geriatrics
- consultation to cardiology extends time to surgery & increases length of hospital stay[83]
- removal of indwelling urinary catheters[6]
- perioperative antibiotics reduce the incidence of wound infections & urinary tract infections[46]
- initiate 2 hours before surgery
- continue for 24 hours after surgery
- goal is to prevent Staphylococcus aureus infection
- fragility hip fractures in geriatric patients[86]
- falling from a standing height or less[101]
- preoperative femoral nerve block
- a geriatric pain management protocol
- perioperative tranexamic acid infusion (limit postoperative blood loss)
- restrictive blood transfusion postoperatively
- nutrition optimization plan
- evaluation for secondary causes of osteoporosis
- isolated greater trochanteric fracture is nonsurgical unless if intertrochanteric extension; however 91% may show such extension by MRI[88]
- family visits with food & personal items[6]
- early postoperative ambulation has not been shown to reduce postoperative delirium[6]
- pain management:
- surgery
- open reduction, internal fixation
- arthroplasty
- hemiarthroplasty
- arthroplasty/hemiarthroplasty often used in elderly due to risk of avascular osteonecrosis & failure of fixation with open reduction internal fixation
- arthroplasty may yield better long-term hip function; however intraoperative blood loss is greater & operative time is greater, & there may be a greater risk of dislocation[23]
- severe osteoarthritis or rheumatoid arthritis damaging the acetabulum favors arthroplasty
- total hip arthroplasty vs hemiarthroplasty have similar reoperation rates after 2 years[81][84]
- surgical repair within 24-48 hours[87], within 24 hours[72]
- associated with better return of function & reduced mortality[7]
- a wait time of 24 hours may represent a threshold of increased risk for delaying hip fracture surgery[73]
- surgery within 6 hours of presentation results in a 1-day shorter hospital stay[85]
- better outcomes if surgery within 4 days (OR = 1.3)[17];
- surgical delay for 5 or more days does not adversely affect outcomes[25]
- preoperative echocardiogram delays surgical intervention within 48 hours[87]
- active medical illness or advanced comorbid conditions may warant preoperative medical evaluation prior to surgery[72]
- delay surgical repair for at least 4-6 weeks after myocardial infarction[6]
- surgical repair reduces mortality among nursing home residents with advanced dementia[76]
- non-operative management is a viable option for frail institutionalized patients with a proximal femoral fracture at the end of life[95]
- perioperative clopidogrel is safe[32]
- anesthesia
- no difference in pain outcomes between spinal anesthesia & general anesthesia[96]
- similar long-term outcomes between spinal anesthesia & general anesthesia[102]
- general anesthesia associated with worse outcomes than spinal anesthesia or epidural anesthesia (OR = 1.3)[17]
- longer duration of general anesthesia associated with increased risk for delirium[79]
- regional anesthesia, compared with general anesthesia,is associated with slightly shorter length of stay but not with lower 30-day mortality[44][90]
- regional anesthesia is associated with lower in-hospital mortality & fewer complications than general anesthesia[48]
- spinal anesthesia associated with higher discharge home rate compared with general anesthesia[90]
- regional anesthesia is associated with better analgesia than standard pain control regimens & reduces need for intravenous opioids[50]
- sedation level during spinal anesthesia does not affect incidence of postoperative delirium[78]
- exception is patients with Charlson comorbidity index of 0.
- spinal anesthesia generally is assumed to be safer than general anesthesia for patients at high risk for perioperative morbidity and mortality
- complications at 60 days similar, regardless of anesthesia strategy[91]
- regional anesthesia compared with general anesthesia did not reduce the incidence &/or severity of postoperative delirium in older adults undergoing surgical repair of fragility hip fracture[92]
- adequate hydration & pain control may reduce risk of postoperative delirium[98]
- anticoagulation
- high risk for venous thromboembolism
- both mechanical & pharmacologic prophylaxis for venous thromboembolism
- intermittent pneumatic compression for 10 days
- pharmacologic prophylaxis: minimum duration 10-14 days, up to 35 days[96]
- 4-5 weeks of anticoagulation is standard of care[6]
- aspirin associated with similar mortality & pulmonary embolism as enoxaparin; DVT (most distal) more common with aspirin (2.5% vs 1.7%)[100]
- see rehabilitation (below)
- rehabilitation
- goal is to return to prior level of functioning
- begin rehabilitation on post-operative day 1
- physical therapy 5 or more times/week
- when in doubt, confirm weight-bearing & range of motion restriction with orthopedic surgeon
- avoid early passive range of motion & resistance strengthening
- range of motion & resistance strengthening result in similar ambulation outcomes[82]
- consider increased energy expenditure during mobility
- weight-bearing
- 6-8 weeks after pinning
- 2-3 days after placement of a compression screw
- 1-2 days after prosthetic hip replacement
- anticoagulation for 4-5 weeks as for hip arthroplasty[12]
- ted hose & pneumatic compression device until ambulatory
- enoxaparin 40 mg SQ QD or direct oral anticoagulant (apixaban, rivaroxaban)
- Active Care + SFT may be alternative to enoxaparin
- inpatient rehabilitation with lowest risk of mortality[71]
- need concomitant medical diagnosis for inpatient rehab under Medicare guidelines
- intense intervention may improve outcome[9]
- a home-based exercise program improves some measures of physical function after standard rehabilitation for hip fracture[35]
- home rehabilitation
- higher risk of falls than no rehabilitation[71]
- lower risk of long-term care admission after discharge from hospital[71]
- cognitive impairment is associated with less frequent ambulatory independence but is not a contraindication to rehabilitation[6][60]
- human growth hormone 20 ug/kg/day may be of benefit[65]
- evidence is weak for protein & energy supplementation[64]
- nutritional intervention unlikely to provide any benefit for quality adjusted life years[66]
- RED FLAGS: sudden or steady increase in pain
- pain control[6]
- pain is common regardless of surgical management[76]
- morphine is drug of choice
- pain control protocol using morphine to keep pain levels < than 3/10[29]
- pain control in demented patients frequently inadequate
- ultrasound-guided femoral nerve block
- anemia
- iron supplementation for anemia after surgery for hip fracture not beneficial[19]
- liberal red blood cell transfusions after hip fracture surgery do not improve outcomes
- withhold red blood cell transfusions in older patients who undergo hip fracture surgery until blood hemoglobin drops below 8 g/dL or symptoms develop[26][61]
Prognosis:
- 54-60% walk unaided after 1 year
- ref[38] suggests < 50%
- 1 year mortality is 14-24% (Medicare recipients)
- prefracture functional status is the strongest predictor of functional outcome
- most likely outcome for 80 yo woman with intact iADLs is full recovery to prefracture status in 6 months[6]*
- dementia leads to poorer outcomes (GRS9)[6]
- for risk of poor outcome related to transitional care see transitional care
* however, references cited do not unambiguously support an expectation of full recovery (also see falls in the elderly, refs 74,75)
Prevention:
- prevent falls
- minimize osteoporosis
- alendronate, risedronate, zoledronate, & denosumab prevent hip fractures, vertebral fractures & other factures[51]
- zoledronate may prevent subsequent fractures[16]
- initiate IV zoledronate within 14-90 days after surgery[101]
- zoledronate may prevent subsequent fractures[16]
- calcium plus vitamin D may be of benefit[30]
- alendronate, risedronate, zoledronate, & denosumab prevent hip fractures, vertebral fractures & other factures[51]
- hip protectors: no evidence of benefit[1]
- folate 5 mg QD plus mecobalamine 1500 ug/day reduce hip fractures in patients with elevated serum homocysteine[10]
- cataract surgery may reduce risk of hip fracture (RR=0.84)[27]
- secondary prevention:
- vitamin D 2000 IU/day reduced re-admissions after hip fracture in elderly women with vitamin D deficiency[24]
- bisphosphonates reduce subsequent nonvertebral fractures[77]
- community-based program for fracture risk screening is associated with fewer hip fractures in older women, but not a reduction in overall fractures[74]
- 2.6% vs 3.5%, NNT=111
- screening increased bisphosphonate use 15% vs 4%[74]
- decreases in Medicare reimbursement for DEXA BMD has resulted in fewer DEXAs performed[75]
More general terms
More specific terms
Additional terms
- arthroplasty
- falls in the elderly
- femur
- FRAX fracture risk assessment tool
- Garden Classification of hip fracture
- hip joint
- hip pain
- hip protector
- osteoporosis
References
- ↑ 1.0 1.1 Journal Watch 20(24):189, 2000 Kannus et al Prevention of hip fracture in elderly people with use of a hip protector. N Engl J Med 343:1506, 2000 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11087879
Parker MJ, Gillespie WJ, Gillespie LD. Effectiveness of hip protectors for preventing hip fractures in elderly people: systematic review. BMJ. 2006 Mar 11;332(7541):571-4. Epub 2006 Mar 2. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16513687
de Rooij SE. Hip protectors to prevent femoral fracture. BMJ. 2006 Mar 11;332(7541):559-60. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16528058 - ↑ Greendale G, Syllabus on Osteoporosis, Iris Cantor- UCLA Women's Health Center Osteoporosis Evaluation
- ↑ 3.0 3.1 3.2 3.3 3.4 Genova, A, Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 4.0 4.1 Journal Watch 22(5):39, 2002 Wu F et al Fractures between the ages of 20 and 50 years increase women's risk of subsequent fractures. Arch Intern Med 162:33, 2002 PMID: https://www.ncbi.nlm.nih.gov/pubmed/11784217
- ↑ 5.0 5.1 5.2 5.3 Greendale GA, Intensive Course in Geriatric Medicine & Board Review, Marina Del Ray, CA, Sept 12-15, 2001
- ↑ 6.00 6.01 6.02 6.03 6.04 6.05 6.06 6.07 6.08 6.09 6.10 6.11 6.12 6.13 6.14 6.15 Geriatrics Review Syllabus, American Geriatrics Society, 5th edition, 2002-2004
Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ 7.0 7.1 Journal Watch 24(10):81, 2004 Orosz GM, Magaziner J, Hannan EL, Morrison RS, Koval K, Gilbert M, McLaughlin M, Halm EA, Wang JJ, Litke A, Silberzweig SB, Siu AL. Association of timing of surgery for hip fracture and patient outcomes. JAMA. 2004 Apr 14;291(14):1738-43. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15082701
- ↑ 8.0 8.1 Journal Watch 24(12):94, 2004 van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, van der Klift M, de Jonge R, Lindemans J, de Groot LC, Hofman A, Witteman JC, van Leeuwen JP, Breteler MM, Lips P, Pols HA, Uitterlinden AG. Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med. 2004 May 13;350(20):2033-41. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15141041
McLean RR, Jacques PF, Selhub J, Tucker KL, Samelson EJ, Broe KE, Hannan MT, Cupples LA, Kiel DP. Homocysteine as a predictive factor for hip fracture in older persons. N Engl J Med. 2004 May 13;350(20):2042-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15141042
Raisz LG Homocysteine and osteoporotic fractures--culprit or bystander? N Engl J Med. 2004 May 13;350(20):2089-90. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15141048 - ↑ 9.0 9.1 Journal Watch 24(19):152-53, 2004 Binder EF, Brown M, Sinacore DR, Steger-May K, Yarasheski KE, Schechtman KB. Effects of extended outpatient rehabilitation after hip fracture: a randomized controlled trial. JAMA. 2004 Aug 18;292(7):837-46. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15315998
- ↑ 10.0 10.1 10.2 Journal Watch 25(8):64, 2005 Sato Y, Honda Y, Iwamoto J, Kanoko T, Satoh K. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA. 2005 Mar 2;293(9):1082-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/15741530
- ↑ 11.0 11.1 11.2 Roche JJW et al, Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: Prospective observational cohort study. BMJ 2005; 331:1374 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16299013
- ↑ 12.0 12.1 Bjornara BT et al, Frequency and timing of clinical venous thromboembolism after major joint surgery. J Bone Joint Surg Br 2006; 88:386 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16498018
- ↑ Bottle A & Aylin P Mortality associated with delay in operative after hip fracture: Observational study. BMJ 2006; 332:947 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16554334
- ↑ 14.0 14.1 Yang YX, Lewis JD, Epstein S, Metz DC. Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA. 2006 Dec 27;296(24):2947-53. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17190895
- ↑ UpToDate 14.1 http://www.utdol.com
- ↑ 16.0 16.1 Lyles KW et al, Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med 2007 357:[ePub] http://dx.doi.org/10.1056/NEJMoa74941 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17878149
- ↑ 17.0 17.1 17.2 Radcliff TA et al, Patient risk factors, operative care, and outcomes among older community-dwelling male veterans with hip fracture. J Bone Joint Surg Am 2008, 90:34 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18171955
- ↑ 18.0 18.1 Cauley JA et al Serum 25-Hydroxyvitamin D Concentrations and Risk for Hip Fractures. Ann Intern Med. 2008 Aug 19;149(4):242-50 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18711154
- ↑ 19.0 19.1 Parker MJ. Iron supplementation for anemia after hip fracture surgery: A randomized trial of 300 patients. J Bone Joint Surg Am 2010 Feb; 92:265 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20124051 <Internet> http://dx.doi.org/10.2106/JBJS.I.00883
- ↑ Haentjens P et al Meta-analysis: Excess Mortality After Hip Fracture Among Older Women and Men Annals of Internal Medicine 152(6) 2010 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20231569 <Internet> http://www.annals.org/content/152/6/380.abstract
- ↑ 21.0 21.1 Kirby MW and Spritzer C. Radiographic detection of hip and pelvic fractures in the emergency department. AJR Am J Roentgenol 2010 Apr; 194:1054. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20308510
- ↑ 22.0 22.1 Lee JS et al. Subclinical thyroid dysfunction and incident hip fracture in older adults. Arch Intern Med 2010 Nov 22; 170:1876 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21098345
- ↑ 23.0 23.1 van den Bekerom MP et al A comparison of hemiarthroplasty with total hip replacement for displaced intracapsular fracture of the femoral neck: a randomised controlled multicentre trial in patients aged 70 years and over. J Bone Joint Surg Br. 2010 Oct;92(10):1422-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20884982
Blomfeldt R et al A randomised controlled trial comparing bipolar hemiarthroplasty with total hip replacement for displaced intracapsular fractures of the femoral neck in elderly patients. J Bone Joint Surg Br. 2007 Feb;89(2):160-5 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17322427
Keating JF et al Displaced intracapsular hip fractures in fit, older people: a randomised comparison of reduction and fixation, bipolar hemiarthroplasty and total hip arthroplasty. Health Technol Assess. 2005 Oct;9(41):iii-iv, ix-x, 1-65. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16202351
Hopley C et al Primary total hip arthroplasty versus hemiarthroplasty for displaced intracapsular hip fractures in older patients: systematic review. BMJ. 2010 Jun 11;340:c2332. doi:http://dx.doi.org/ 10.1136/bmj.c2332. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20543010 - ↑ 24.0 24.1 Bischoff-Ferrari HA, Dawson-Hughes B, Platz A, et al. Effect of high-dosage cholecalciferol and extended physiotherapy on complications after hip fracture: A randomized controlled trial. Arch Intern Med 2010; 170(9):813-820 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20458090
- ↑ 25.0 25.1 Vidan MT et al. Causes and effects of surgical delay in patients with hip fracture: A cohort study. Ann Intern Med 2011 Aug 16; PMID: https://www.ncbi.nlm.nih.gov/pubmed/21844548
- ↑ 26.0 26.1 Carson JL et al. Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med 2011 Dec 29; 365:2453 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22168590
- ↑ 27.0 27.1 Tseng VL et al Risk of Fractures Following Cataract Surgery in Medicare Beneficiaries JAMA. 2012;308(5):493-501 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22851116 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1273017
- ↑ 28.0 28.1 Carriero FP, Christmas C. In the Clinic. Hip fracture. Ann Intern Med 6 December 2011; 155(11):ITC6-1-16 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22147729
Pioli G, Laretani F, Davoli ML, et al. Older people with hip fracture and IADL disability require earlier surgery. J Gerontol A Biol Sci Med Sci PMID: https://www.ncbi.nlm.nih.gov/pubmed/22454376 - ↑ 29.0 29.1 Sieber FE, Mears S, Lee H, Gottschalk A. Postoperative opioid consumption and its relationship to cognitive function in older adults with hip fracture. J Am Geriatr Soc 2011; 59:2256-2262 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22092232
- ↑ 30.0 30.1 Boonen S, Lips P, Bouillon R, et al. Need for additional calcium to reduce the risk of hip fracture with vitamin D supplementation: evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab 2007; 92:1415-1423 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17264183
- ↑ 31.0 31.1 Moyer VA et al Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med. 26 February 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440163 <Internet> http://annals.org/article.aspx?articleid=1655858
Nestle M and Nesheim MC To Supplement or Not to Supplement: The U.S. Preventive Services Task Force Recommendations on Calcium and Vitamin D Ann Intern Med. 26 February 2013 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23440174 <Internet> http://annals.org/article.aspx?articleid=1655860 - ↑ 32.0 32.1 Feely MA et al. Safety of clopidogrel in hip fracture surgery. Mayo Clin Proc 2013 Feb; 88:149. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23374618
- ↑ 33.0 33.1 Bakken MS et al Increased Risk of Hip Fracture Among Older People Using Antidepressant Drugs. Age Ageing. 2013;42(4):514-520. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23438446 <Internet> http://www.medscape.com/viewarticle/806581
- ↑ Sherrington C, Tiedemann A, Cameron I. Physical exercise after hip fracture: an evidence overview. Eur J Phys Rehabil Med. 2011 Jun;47(2):297-307 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21555983
- ↑ 35.0 35.1 Latham NK et al Effect of a Home-Based Exercise Program on Functional Recovery Following Rehabilitation After Hip Fracture. A Randomized Clinical Trial. JAMA. 2014;311(7):700-708. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24549550 https://jama.jamanetwork.com/article.aspx?articleid=1829991
- ↑ 36.0 36.1 Adams AL, Schiff MA, Koepsell TD et al Physician consultation, multidisciplinary care, and 1-year mortality in Medicare recipients hospitalized with hip and lower extremity injuries. J Am Geriatr Soc. 2010 Oct;58(10):1835-42. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20929461
- ↑ 37.0 37.1 Friedman SM, Mendelson DA, Bingham KW, Kates SL. Impact of a comanaged Geriatric Fracture Center on short- term hip fracture outcomes. Arch Intern Med. 2009 Oct 12;169(18):1712-7. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19822829
- ↑ 38.0 38.1 Vochteloo AJ, Moerman S, Tuinebreijer WE et al More than half of hip fracture patients do not regain mobility in the first postoperative year. Geriatr Gerontol Int. 2013 Apr;13(2):334-41. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22726959
- ↑ Mak JC, Cameron ID, March LM Evidence-based guidelines for the management of hip fractures in older persons: an update. Med J Aust. 2010 Jan 4;192(1):37-41. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20047547
- ↑ Nikkel LE, Fox EJ, Black KP et al Impact of comorbidities on hospitalization costs following hip fracture. J Bone Joint Surg Am. 2012 Jan 4;94(1):9-17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22218377
- ↑ Sieber FE, Mears S, Lee H, Gottschalk A. Postoperative opioid consumption and its relationship to cognitive function in older adults with hip fracture. J Am Geriatr Soc. 2011 Dec;59(12):2256-62. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22092232
- ↑ Carson JL, Terrin ML, Magaziner J et al Transfusion trigger trial for functional outcomes in cardiovascular patients undergoing surgical hip fracture repair (FOCUS). Transfusion. 2006 Dec;46(12):2192-206. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17176334
- ↑ Carson JL, Terrin ML, Noveck H et al Liberal or restrictive transfusion in high-risk patients after hip surgery. N Engl J Med. 2011 Dec 29;365(26):2453-62 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22168590
- ↑ 44.0 44.1 Patorno E et al. Comparative safety of anesthetic type for hip fracture surgery in adults: Retrospective cohort study. BMJ 2014 Jun 27; 348:g4022 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24972901 <Internet> http://www.bmj.com/content/348/bmj.g4022
Neuman MD et al. Anesthesia technique, mortality, and length of stay after hip fracture surgery. JAMA 2014 Jun 25; 311:2508 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25058085 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1883020 - ↑ 45.0 45.1 Foundation for Osteoporosis Research an Education (FORE) 10 Year Fracture Risk Ralculator https://riskcalculator.fore.org
- ↑ 46.0 46.1 Rao SS, Cherukuri M Management of Hip Fracture: The Family Physician's Role. Am Fam Physician. 2006 Jun 15;73(12):2195-2200 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/16836036 <Internet> http://www.aafp.org/afp/2006/0615/p2195.html
- ↑ 47.0 47.1 Prestmo A et al. Comprehensive geriatric care for patients with hip fractures: A prospective, randomised, controlled trial. Lancet 2015 Feb 4 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25662415 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962409-0/abstract
- ↑ 48.0 48.1 Chu CC, Weng SF, Chen KT et al. Propensity score-matched comparison of postoperative adverse outcomes between geriatric patients given a general or a neuraxial anesthetic for hip surgery. Anesthesiology 2015 May 8; 123:136 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25955981
- ↑ 49.0 49.1 Le Manach Y, Collins G, Bhandari M et al Outcomes After Hip Fracture Surgery Compared With Elective Total Hip Replacement. JAMA. 2015 Sep 15;314(11):1159-66 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26372585
- ↑ 50.0 50.1 Ritcey B et al. Regional nerve blocks for hip and femoral neck fractures in the emergency department: A systematic review. CJEM 2015 Sep 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26330019
- ↑ 51.0 51.1 Reid IR Efficacy, effectiveness and side effects of medications used to prevent fractures. J Intern Med. 2015 Jun;277(6):690-706 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25495429
- ↑ American Academy of Orthopaedic Surgeons AAOS recommends specific treatment, rehabilitation for elderly patients with hip fractures. EurekAlert. Dec 9, 2015 http://www.eurekalert.org/pub_releases/2015-12/aaoo-ars120915.php
- ↑ 53.0 53.1 53.2 Nikkel LE et al. Length of hospital stay after hip fracture and risk of early mortality after discharge in New York state: Retrospective cohort study. BMJ 2015 Dec 10; 351:h6246 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26655876
- ↑ Dickman E, Pushkar I, Likourezos A et al Ultrasound-guided nerve blocks for intracapsular and extracapsular hip fractures. Am J Emerg Med. 2016 Mar;34(3):586-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/26809928
- ↑ Regan EA, Radcliff TA, Henderson WG Improving hip fractures outcomes for COPD patients. COPD. 2013 Feb;10(1):11-9. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23272668
- ↑ Marsland D, Mears SC, Kates SL. Venous thromboembolic prophylaxis for hip fractures. Osteoporos Int. 2010 Dec;21(Suppl 4):S593-604. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21057999
- ↑ 57.0 57.1 Bellelli G, Mazzola P, Morandi A et al Duration of postoperative delirium is an independent predictor of 6-month mortality in older adults after hip fracture. J Am Geriatr Soc. 2014 Jul;62(7):1335-40. PMID: https://www.ncbi.nlm.nih.gov/pubmed/2489094
- ↑ 58.0 58.1 Krogseth M, Wyller TB, Engedal K, Juliebo V. Delirium is a risk factor for institutionalization and functional decline in older hip fracture patients. J Psychosom Res. 2014 Jan;76(1):68-74. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24360144
- ↑ Beloosesky Y, Grinblat J, Epelboym B Functional gain of hip fracture patients in different cognitive and functional groups. Clin Rehabil. 2002 May;16(3):321-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/12017519
- ↑ 60.0 60.1 Morghen S, Gentile S, Ricci E Rehabilitation of older adults with hip fracture: cognitive function and walking abilities. J Am Geriatr Soc. 2011 Aug;59(8):1497-502. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21797828
- ↑ 61.0 61.1 Gruber-Baldini AL, Marcantonio E, Orwig D et al Delirium outcomes in a randomized trial of blood transfusion thresholds in hospitalized older adults with hip fracture. J Am Geriatr Soc. 2013 Aug;61(8):1286-95. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23898894 Free PMC Article
- ↑ Jettoo P, Kakwani R, Junejo S, Talkhani I, Dixon P. Pre-operative echocardiogram in hip fracture patients with cardiac murmur--an audit. J Orthop Surg Res. 2011 Sep 23;6:49. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21943077 Free PMC Article
- ↑ Ricci WM, Della Rocca GJ, Combs C, Borrelli J. The medical and economic impact of preoperative cardiac testing in elderly patients with hip fractures. Injury. 2007 Sep;38 Suppl 3:S49-52. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17723792
- ↑ 64.0 64.1 Avenell A, Handoll HH. Nutritional supplementation for hip fracture aftercare in older people. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD001880. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20091525
- ↑ 65.0 65.1 Van der Lely AJ, Lamberts SW, Jauch KW Use of human GH in elderly patients with accidental hip fracture. Eur J Endocrinol. 2000 Nov;143(5):585-92. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11078981 Free Article
- ↑ 66.0 66.1 Wyers CE, Reijven PL, Evers SM Cost-effectiveness of nutritional intervention in elderly subjects after hip fracture. A randomized controlled trial. Osteoporos Int. 2013 Jan;24(1):151-62. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22638708 Free PMC Article
- ↑ 67.0 67.1 Friedman SM, Menzies IB, Bukata SV et al Dementia and hip fractures: development of a pathogenic framework for understanding and studying risk. Geriatr Orthop Surg Rehabil. 2010 Nov;1(2):52-62. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23569663 Free PMC Article
- ↑ Menzies IB, Mendelson DA, Kates SL, Friedman SM. Prevention and clinical management of hip fractures in patients with dementia. Geriatr Orthop Surg Rehabil. 2010 Nov;1(2):63-72. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23569664 Free PMC Article
- ↑ Magaziner J, Hawkes W, Hebel JR et al Recovery from hip fracture in eight areas of function. J Gerontol A Biol Sci Med Sci. 2000 Sep;55(9):M498-507. PMID: https://www.ncbi.nlm.nih.gov/pubmed/10995047
- ↑ 70.0 70.1 Shin WC et al. Preoperative prevalence of and risk factors for venous thromboembolism in patients with a hip fracture: An indirect multidetector CT venography study. J Bone Joint Surg Am 2016 Dec 21; 98:2089. http://jbjs.org/content/98/24/2089
- ↑ 71.0 71.1 71.2 71.3 Seitz DP, Gill SS, Austin PC, et al. Rehabilitation of older adults with dementia after hip fracture. J Am Geriatr Soc. 2016 Jan;64(1):47-54 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26782851
- ↑ 72.0 72.1 72.2 Bhandari M, Swiontkowsk M. Management of Acute Hip Fracture. N Engl J Med 2017; 377:2053-2062. Nov 23, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29166235 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcp1611090
- ↑ 73.0 73.1 Pincus D, Ravi B, Wasserstein D Association Between Wait Time and 30-Day Mortality in Adults Undergoing Hip Fracture Surgery. JAMA. 2017;318(20):1994-2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29183076 https://jamanetwork.com/journals/jama/article-abstract/2664460
Vrahas MS, Sax HC Timing of Operations and Outcomes for Patients With Hip Fracture
It's Probably Not Worth the Wait. JAMA. 2017;318(20):1981-1982 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29183051 https://jamanetwork.com/journals/jama/article-abstract/2664434 - ↑ 74.0 74.1 74.2 Shepstone L, Lenaghan E, Cooper C et al Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. The Lancet. Dec 15, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29254858 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32640-5/fulltext
Cauley JA A two-step screening process reduces hip fractures. The Lancet. Dec 15, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29254857 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33295-6/fulltext - ↑ 75.0 75.1 Michael Lewiecki E, Wright NC, Curtis JR et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int 2017 Dec 27 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29282482
- ↑ 76.0 76.1 76.2 Berry SD, Rothbaum RR, Kiel DP et al Association of Clinical Outcomes With Surgical Repair of Hip Fracture vs Nonsurgical Management in Nursing Home Residents With Advanced Dementia. JAMA Intern Med. 2018 Jun 1;178(6):774-780 PMID: https://www.ncbi.nlm.nih.gov/pubmed/29801122 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2680317
Mehr DR, Tatum PE III, Crist BD Hip Fractures in Patients With Advanced DementiaWhat Treatment Provides the Best Palliation? JAMA Intern Med. Published online May 7, 2018. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29801116 https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2680316 - ↑ 77.0 77.1 Desai RJ, Mahesri M, Abdia Y et al Association of Osteoporosis Medication Use After Hip Fracture With Prevention of Subsequent Nonvertebral Fractures. An Instrumental Variable Analysis. JAMA Network Open. 2018;1(3):e180826. Not indexed in PubMed https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2688348
Bauer DC Osteoporosis Treatment After Hip FractureB. ad News and Getting Worse. JAMA Network Open. 2018;1(3):e180844 Not indexed in PubMed https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2688341 - ↑ 78.0 78.1 Sieber FE, Neufeld JJ, Gottschalk A et al Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium. The STRIDE Randomized Clinical Trial. JAMA Surg. Published online August 8, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30090923 https://jamanetwork.com/journals/jamasurgery/fullarticle/2695519
Whitlock EL, Finlayson E. Depth of Propofol Sedation and Postoperative Delirium. The Jury Is Still Out. JAMA Surg. Published online August 8, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30090922 https://jamanetwork.com/journals/jamasurgery/fullarticle/2695516 - ↑ 79.0 79.1 Ravi B, Pincus D, Choi S et al Association of duration of surgery with postoperative delirium among patients receiving hip fracture repair JAMA Netw Open. 2019;2(2):e190111. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30794305
- ↑ 80.0 80.1 Meyer HE, Willett WC, Fung TT, Holvik K, Feskanich D. Association of high intakes of vitamins B6 and B12 from food and supplements with risk of hip fracture among postmenopausal women in the Nurses' Health Study. JAMA Netw Open 2019 May 3; 2:e193591. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31074816 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2733176
- ↑ 81.0 81.1 The HEALTH Investigators Sprague S, Frihagen F, Guerra-Farfan E et al Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture. N Engl J Med. Sept 26, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31557429 https://www.nejm.org/doi/full/10.1056/NEJMoa1906190
- ↑ 82.0 82.1 Magaziner J, Mangione KK, Orwig D et al. Effect of a multicomponent home-based physical therapy intervention on ambulation after hip fracture in older adults: The CAP randomized clinical trial. JAMA 2019 Sep 10; 322:946. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31503309 https://jamanetwork.com/journals/jama/article-abstract/2749599
- ↑ 83.0 83.1 Bellas N, Stohler S, Staff I, Majk K, Lewis C, Davis S, Kumar M. Impact of preoperative specialty consults on hospitalist comanagement of hip fracture patients. J Hosp Med. 2019 Aug 16;14:E1-E6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31433780 https://www.journalofhospitalmedicine.com/jhospmed/article/206277/hospital-medicine/impact-preoperative-specialty-consults-hospitalist
- ↑ 84.0 84.1 Gjertsen JE Should Total Hip Arthroplasty Be Used for Hip Fracture? N Engl J Med 2019; 381:2261-2262 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31800993 https://www.nejm.org/doi/full/10.1056/NEJMe1913800?query=aging-geriatrics
- ↑ 85.0 85.1 The HIP ATTACK Investigators. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): An international, randomised, controlled trial. Lancet 2020 Feb 9; PMID: https://www.ncbi.nlm.nih.gov/pubmed/32050090 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30058-1/fulltext
- ↑ 86.0 86.1 Morris JC, Moore A, Kahan J et al. Integrated fragility hip fracture program: A model for high quality care. J Hosp Med. 2020 Feb 11;15(2):E1-E7 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32118555 https://www.journalofhospitalmedicine.com/jhospmed/article/217198/hospital-medicine/integrated-fragility-hip-fracture-program-model-high
- ↑ 87.0 87.1 87.2 Sinvani L et al. Preoperative noninvasive cardiac testing in older adults with hip fracture: A multi-site study. J Am Geriatr Soc 2020 Aug; 68:1690 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32526816 https://onlinelibrary.wiley.com/doi/abs/10.1111/jgs.16555
- ↑ 88.0 88.1 88.2 88.3 Haj-Mirzaian A et al Use of advanced imaging for radiographically occult hip fracture in elderly patients: A systematic review and meta-analysis. Radiology 2020 Sep; 296:521. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32633673 https://pubs.rsna.org/doi/10.1148/radiol.2020192167
Wilson MP et al. Diagnostic accuracy of limited MRI protocols for detecting radiographically occult hip fractures: A systematic review and meta-analysis. AJR Am J Roentgenol 2020 Sep; 215:559 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32755182 https://www.ajronline.org/doi/10.2214/AJR.19.22676 - ↑ 89.0 89.1 Goubar A, Martin FC, Potter C et al The 30-day survival and recovery after hip fracture by timing of mobilization and dementia: a UK database study. Bone Joint J. 2021 Jul;103-B(7):1317-1324 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34192935
- ↑ 90.0 90.1 90.2 Rodkey DL,Pezzi A, Hymes R. Effects of Spinal Anesthesia in Geriatric Hip Fracture. A Propensity Matched Study. J Orthop Trauma. 2021 Sep 21 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34561407 https://journals.lww.com/jorthotrauma/Abstract/9000/Effects_of_Spinal_Anesthesia_in_Geriatric_Hip.97955.aspx
- ↑ 91.0 91.1 Neuman MD, Feng R, Carson JL et al. Spinal anesthesia or general anesthesia for hip surgery in older adults. N Engl J Med 2021 Oct 9; PMID: https://www.ncbi.nlm.nih.gov/pubmed/34623788 https://www.nejm.org/doi/10.1056/NEJMoa2113514
- ↑ 92.0 92.1 Li T, Li J, Yuan L et al Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture SurgeryThe RAGA Randomized Trial. JAMA. Published online December 20, 2021. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34928310 https://jamanetwork.com/journals/jama/fullarticle/2787494
- ↑ 93.0 93.1 Wang Y, Tang J, Zhou F et al. Comprehensive geriatric care reduces acute perioperative delirium in elderly patients with hip fractures: a meta-analysis. Medicine (Baltimore). 2017;96(26):e7361 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28658156 PMCID: PMC5500078 Free PMC article https://journals.lww.com/md-journal/Fulltext/2017/06300/Comprehensive_geriatric_care_reduces_acute.64.aspx
Shields L, Henderson V, Caslake R. Comprehensive geriatric assessment for prevention of delirium after hip fracture: a systematic review of randomized controlled trials. J Am Geriatr Soc. 2017;65(7):1559-1565 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28407199 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.14846 - ↑ Berry SD, Kiel DP, Colon-Emeric C. Hip fractures in older adults in 2019. JAMA. 2019;321(22):2231-2232 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31074763 PMCID: PMC6800121 Free PMC article https://jamanetwork.com/journals/jama/fullarticle/2733663
- ↑ 95.0 95.1 Loggers SAI et al. Evaluation of quality of life after nonoperative or operative management of proximal femoral fractures in frail institutionalized patients: The FRAIL-HIP study. JAMA Surg 2022 Mar 2; PMID: https://www.ncbi.nlm.nih.gov/pubmed/35234817 https://jamanetwork.com/journals/jamasurgery/fullarticle/2789490
- ↑ 96.0 96.1 96.2 Neuman MD et al. Pain, analgesic use, and patient satisfaction with spinal versus general anesthesia for hip fracture surgery: A randomized clinical trial. Ann Intern Med 2022 Jun 14; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35696684 https://www.acpjournals.org/doi/10.7326/M22-0320
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 19 American College of Physicians, Philadelphia 2022
- ↑ 98.0 98.1 Zang H, Lu Y, Liu M et al Strategies for prevention of postoperative delirium: a systematic review and meta-analysis of randomized studies. Crit Care. 2013 Mar 18;17(2):R47. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23506796 PMCID: PMC3672487 Free PMC article. Review.
- ↑ 99.0 99.1 99.2 Abraham MK, Cimino-Fiallos N Falls in the Elderly: Causes, Injuries, and Prevention. Medscape. Nov 23 2022 https://reference.medscape.com/slideshow/falls-in-the-elderly-6012395
- ↑ 100.0 100.1 Major Extremity Trauma Research Consortium (METRC). Aspirin or low-molecular-weight heparin for thromboprophylaxis after a fracture. N Engl J Med 2023 Jan 19; 388:203. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36652352 https://www.nejm.org/doi/10.1056/NEJMoa2205973
- ↑ 101.0 101.1 101.2 101.3 NEJM knowledge+ Rheumatology
- ↑ 102.0 102.1 Vail EA et al. Long-term outcomes with spinal versus general anesthesia for hip fracture surgery: A randomized trial. Anesthesiology 2024 Mar 1; 140:375. PMID: https://www.ncbi.nlm.nih.gov/pubmed/37831596 Free article https://pubs.asahq.org/anesthesiology/article/140/3/375/139299/Long-term-Outcomes-with-Spinal-versus-General
- ↑ 103.0 103.1 Murray GR, Cameron ID, Cumming RG. The consequences of falls in acute and subacute hospitals in Australia that cause proximal femoral fractures. J Am Geriatr Soc. 2007 Apr;55(4):577-82. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17397437
- ↑ 104.0 104.1 Zapatero A, Barba R, Canora J et al Hip fracture in hospitalized medical patients. BMC Musculoskelet Disord. 2013 Jan 8;14:15. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23298165 PMCID: PMC3561229 Free PMC article.