What are the AAOS treatment guidelines for hip fracture in elderly patients?

Updated: Jan 08, 2019
  • Author: Naveenpal S Bhatti, MD; Chief Editor: Sherwin SW Ho, MD  more...
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The American Academy of Orthopaedic Surgeons released new guidelines on the management of hip fractures in patients over the age of 65. Recommendations supported by strong evidence include the following: [7, 8]

  • Regional analgesia can be used to improve preoperative pain control in patients with hip fracture.

  • In patients undergoing hip fracture surgery, similar outcomes can be achieved with general or spinal anesthesia.

  • Arthroplasty should be used for patients with unstable (displaced) femoral neck fractures.

  • Use of a cephalomedullary device is recommended for the treatment of patients with subtrochanteric or reverse obliquity fractures.

  • In asymptomatic postoperative hip fracture patients, a blood transfusion threshold of no higher than 8g/dl should be used.

  • Intensive post-discharge physical therapy improves functional outcomes.

  • Use of an interdisciplinary care program in hip fracture patients with mild to moderate dementia improves functional outcomes.

  • Multimodal pain management should be used after hip fracture surgery.

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