Hip Fracture: The Choice of Surgery

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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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APA

Palm, H. (2017). Hip Fracture: The Choice of Surgery. In Practical Issues in Geriatrics (pp. 81–96). Springer Nature. https://doi.org/10.1007/978-3-319-43249-6_6

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