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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Answer

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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