Pre-hospital immobilisation for neck of femur fractures in australia – a break in the evidence

Abstract

Neck of femur (NOF) fractures present a significant challenge for healthcare systems and are associated with major complications and high mortality. Hospital clinical pathways aim to improve care and optimise outcomes for individuals sustaining NOF fractures; however, these pathways exclude the pre-hospital management of suspected NOF fractures. Therefore, there remains a lack of evidenced-based standardisation for pre-hospital management. To date, research into pre-hospital management of NOF fractures has mostly focussed on pain relief, with very little research examining immobilisation techniques. This is despite immobilisation offering great clinical benefit for other long bone fractures. Unlike hospital clinical pathways that undergo annual reports and reviews, pre-hospital guidelines for NOF fracture immobilisation have received little attention in the past decade. Given advances in research-informed practice for pre-hospital management of other fractures, it seems timely and pertinent to examine current clinical practice guidelines for NOF fractures, focusing on the appropriateness of current immobilisation techniques.