![]() 28Īmerican Academy of Orthopaedic Surgeons clinical practice guidelineĪntibiotics with activity against Staphylococcus aureus are recommended one to two hours before hip surgery and 24 hours postoperatively. Early operative management improves pain control, decreases length of hospitalization, and reduces complications. Operative management of a hip fracture should occur within 24 to 48 hours of injury unless a delay is needed to stabilize comorbidities. If not recognized and treated, these fractures can progress to complete and displaced fractures with high rates of nonunion and avascular necrosis.Ĭross-table lateral hip and anteroposterior pelvis radiography are the initial diagnostic tests for suspected hip fracture. ![]() Insufficiency fractures due to compromised bone strength occur without trauma in postmenopausal women. Femoral neck stress fractures typically occur in dancers 20 to 30 years of age, endurance athletes, and military service members, often because of training overload. Two less common hip fractures can also occur: femoral neck stress fractures and insufficiency fractures. Subsequent care focuses on prevention, with increased physical activity, home safety assessments, and minimizing polypharmacy. Early postoperative mobilization, followed by rehabilitation, improves outcomes. Physicians should be alert for the presence of delirium, which is a common postoperative complication. Medications for venous thromboembolism prophylaxis are also recommended. Pre- and postoperative antistaphylococcal antibiotics are given to prevent joint infection. Nonsurgical management can be considered for patients who are not good surgical candidates. Fractures are usually managed by surgery, with the approach based on fracture type and location spinal or general anesthesia can be used. Operative management within 24 to 48 hours of the fracture optimizes outcomes. Plain radiography is usually sufficient for diagnosis, but magnetic resonance imaging should be obtained if suspicion of fracture persists despite normal radiography. Hip fractures present with anterior groin pain, inability to bear weight, or a shortened, abducted, externally rotated limb. Modifiable risk factors include low body mass index, having osteoporosis, increased fall risk, medications that increase fall risk or decrease bone mineral density, and substance use. Nonmodifiable risk factors include lower socioeconomic status, older age, female sex, prior fracture, metabolic bone disease, and bony malignancy. Hip fractures are common causes of disability, with mortality rates reaching 30% at one year.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |