Management of hip fractures
The number of geriatric hip fracture is increasing as the society is getting older.
Geriatric hip fracture is caused by osteoporosis, fall, and other related event eg stroke, hypertension, poor vision, side effect of drugs and environment factors. If not properly managed, the long term sequelae includes limitation in mobility, bed sore due to prolong bed rest, chest infection, deep vein thrombosis of lower limb and pulmonary embolism etc.
There are international guidelines for management of geriatric hip fracture, including timely surgery, rehabilitation and treatment of osteoporosis. Timely surgery can stabilized the fracture and avoid prolong bed rest. Consultations from anesthestist and geriatrician before surgery in order to stabilize medical condition. Surgery will be performed under general or spinal anesthesia depends on patient’s condition.
There are different types of surgeries: hemiarthroplasty, dynamic hip screw, intra-manually hip screw etc. After surgery patient is allowed to weight bearing, and will receive physiotherapy, occupation therapy and rehabilitation.
Geriatric hip fracture belongs to fragility fracture, means the bone is not strong enough and will break on fall on level ground. Hence treatment of osteoporosis is a must to prevent further fractures. Medications include: calcium, vitamin D, bisphosphonate, RANKL inhibitor, recombinant human parathyroid hormone.
In summary, geriatric hip fracture is getting more common. By up to date treatment and systemic management, the outcome of geriatric hip fracture is improving.
Dr. Angela Ho