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Hip Fracture: The Choice of Surgery

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Orthogeriatrics

Part of the book series: Practical Issues in Geriatrics ((PIG))

Abstract

Hip fractures are operated with either prosthesis or various kinds of fracture fixation devices, with the aim of immediate mobilisation with full weight-bearing. Challenges are osteoporotic bone, bone vascularity, muscle-attachments, maintaining fracture reduction and slow fracture healing in the often-elderly population and, although reduced in recent years, still 5–20 % of patients need a reoperation, mainly depending on fracture type and choice of surgery. The extensive literature has created partial treatment consensus: Undisplaced femoral neck fractures seem adequately treated with parallel screws/pins or a sliding hip screw, while the displaced femoral neck fractures should be given a prosthesis in elderly patients. The stable trochanteric fractures are well treated with a sliding hip screw, while intramedullary nails seem superior for the unstable trochanteric and the sub-trochanteric fractures. During the last decades surgical guidelines have gained ground, along with national surgical quality standards and registries with possible identification of positive and negative outliers – which is expected to further improve the surgical outcome.

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Authors and Affiliations

  1. Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

    Henrik Palm

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  1. Henrik Palm
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Correspondence to Henrik Palm .

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  1. Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy

    Paolo Falaschi

  2. University College London , London, United Kingdom

    David R. Marsh

Additional information

This book-chapter is a shortened version of: Palm H (2016) An algorithm for hip fracture surgery. Doctor of Medical Science. Dissertation. Copenhagen University. ISBN 978-87-998922-0-4

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Palm, H. (2017). Hip Fracture: The Choice of Surgery. In: Falaschi, P., Marsh, D. (eds) Orthogeriatrics. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-43249-6_6

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  • DOI: https://doi.org/10.1007/978-3-319-43249-6_6

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