Hip Fractures: Treatment Options

Hip Fractures: Treatment Options

This video will provide an overview of treatment options for hip fractures, both with and without surgery. Treatment strategies for hip fractures rely heavily on surgical intervention. However, there are circumstances in which treatment without surgery will be considered. This is particularly relevant in patients who have low functional demands, such as those who rely on a wheelchair for movement or have advanced dementia. In these situations, treatment will include a caring approach focused on pain control and skilled nursing and rehabilitation care.

The decision not to do surgery can be difficult and requires a supportive, team-based approach focused on the patient's and caregiver's goals. In most circumstances, treatment with surgery will be considered for hip fractures. The surgical treatment goals are controlling the patient's pain, restoring alignment of the bone and leg, then getting the patient moving and walking as soon as possible. The timing of surgery is critical in all patient types. Generally, surgical treatment of hip fractures occurs in 48 hours. However, proceeding with this time frame must consider the patient's stability.

In young patients with high-energy traumas, other injuries and treatment may take priority. In older patients, stabilizing existing medical conditions may be a priority before surgery. Speaker1: In surgery, a special operating room table is used to help position the fracture before placing a surgical implant. Often a bone nail and screws are used. Multiple devices can be considered depending on the patient's fracture type. For some patients, a partial hip replacement will be considered, particularly for fractures that occur through the neck of the femur.

After surgery, most patients have a large team that continues to help with their treatment plan. This often includes the surgical team, a medical team, and a rehabilitation team. The medical team will help limit complications after surgery. Twenty to 60% of patients have other medical complications because of a hip fracture, so team-based care between the surgeon and hospital teams is essential. In most situations, early weight-bearing and movement are encouraged to minimize complications. Shortly after surgery, rehabilitation specialists will begin working with patients on getting out of bed.

In summary, treatment for hip fractures relies heavily on surgical approaches. Few circumstances allow treatment without surgery. Regardless of the fracture type, surgical implants will stabilize the fracture. After surgery, multidisciplinary teams will be used. Early weight-bearing and movement are encouraged to prevent complications.