Hip Fractures (Subscribe)

Categories

Femoral Head Fractures (1)
Internet resources relating to Femoral Head Fractures
MeSH Search Term "Hip Fractures"[mesh]
ICD-10 Code S72.0 Fracture of Hip NOS
SNOMED-CT Term Closed fracture of head of femur (disorder) Concept ID: 208526001
See also 41191003 Open fracture of head of femur (disorder)
Femoral Neck Fractures (17)
Internet resources relating to Femoral Neck Fracture. Fractures of the neck, the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures
MeSH Search Term "Femoral Neck Fractures"[mesh]
ICD-10 Code S72.0 Fracture of neck of femur
SNOMED-CT Term Fracture of neck of femur (disorder) Concept ID: 5913000
Synonyms - Fracture of neck of femur
Femoral neck fracture
Fracture of hip
NOF - Fracture of neck of femur
Fractured Greater Trochanter (1)
Internet resources relating to Fractured Greater Trochanter
MeSH Search Term "Hip Fractures"[mesh:noexp]
ICD-10 Code S72.9 Fracture of femur, part unspecified
SNOMED-CT Term Fracture of greater trochanter (disorder) Concept ID: 301034006
IT Fractures (15)
Internet resources relating to Intertrochanteric or Pertrochanteric Hip Fractures
MeSH Search Term "Hip Fractures"[mesh:noexp]
ICD-10 Code S72.1 Pertrochanteric fracture
SNOMED-CT Term Intertrochanteric fracture (disorder) Concept ID: 127287001
Synonyms - Intertrochanteric fracture
Extracapsular fracture of neck of femur
Pertrochanteric fracture of neck of femur
Trochanteric fracture of neck of femur
Intertrochanteric fracture of femur
Intertrochanteric fracture (disorder)
Subtrochanteric Fractures (6)
Internet resources relating to Subtrochanteric Fractures, fractures extending from the Intertrochanteric region into the proximal shaft of the femur
MeSH Search Term "Hip Fractures"[mesh:noexp]
ICD-10 Code S72.2 Subtrochanteric fracture
SNOMED-CT Term Subtrochanteric fracture of femur (disorder) Concept ID: 263229001

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2000 Audit of Deep Wound Infection following Hip Fracture Surgery

1 out of 10 stars (1 vote)

An audit of 171 consecutive hip fractures treated surgically showed a deep wound infection rate of 3.6%. Several shortcomings in the implementation of the infection policy were identified and recommendations to eliminate them introduced. Review of the subsequent 186 patients gave a deep infection rate of 1.1%. Attention to detail and good practice are essential to maintain low wound infection rates.
From Journal RCSE

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2003 Evidence based guidelines for fixing broken hips- an update popular

Update in eMJA of 1996 study "How best to fix broken hips" (qv) Michael N Chilov, Ian D Cameron and Lyn M March MJA 2003; 179 (9): 489-493

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AO Classification of Proximal Femur Fractures popular

AO Classification of Hip Fractures

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1995 Risk Factors for Hip Fracture in White Women

New England Journal of Medicine Volume 332:767-774 March 23, 1995 Number 12 Cummings et al
Conclusions Women with multiple risk factors and low bone density have an especially high risk of hip fracture. Maintaining body weight, walking for exercise, avoiding long-acting benzodiazepines, minimizing caffeine intake, and treating impaired visual function are among the steps that may decrease the risk.

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1997 Bone density and risk of hip fracture in men and women Cross sectional analysis

BMJ 1997;315:221-225 (26 July) Chris E D H De Laet, Ben A van Hout, Huibert Burger, Albert Hofman, Huibert A P Pols
Conclusions: The risk of hip fracture by age and bone density is similar in men and women. The decrease in bone density associated with age makes a limited contribution to the exponential increase of the risk of hip fracture with age.

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1997 Heparin low molecular weight heparin and physical methods for preventing deep vein thrombosis and pulmonary embolism following surgery for hip fractures Cochrane Review

Prophylaxis using heparin and low molecular weight heparin
Heparins and some mechanical pumping devices may help prevent blood clots forming in the legs after surgery for hip fracture
Patients with hip fracture may develop blood clots (thrombosis) in their legs. Some of these blood clots may travel to the lungs and cause a blockage (embolism), which can be fatal. Various drugs and physical devices are sometimes used to try and prevent these complications. This review of randomised trials found that both heparins and mechanical pumping devices significantly decrease the incidence of deep vein thrombosis. There was not enough evidence to conclude about the effect on lung (pulmonary) embolism, mortality or possible side effects for either heparin or mechanical methods.
Handoll HHG, Farrar MJ, McBirnie J, Tytherleigh-Strong G, Milne AA, Gillespie WJ Last assessed as up-to-date: June 23. 2002

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1999 How best to fix a broken hip

Full text version of article in eMJA
Objectives: To develop evidence-based guidelines for the treatment of proximal femoral fractures to optimise functional outcome while minimising length of stay in hospital.
Conclusions: Randomised controlled trial evidence (NHMRC Levels I and II) exists for many, but not all, aspects of hip fracture treatment. There is a need for changes to be made to some aspects of practice in accordance with evidence-based guidelines.
March et al MJA 1999; 170: 489-494

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2002 Prevention and management of hip fracture in older people

SIGN Guideline 56
On successive pages -
Key to Evidence
Introduction
Prevention of Hip Fracture
Pre-hospital management
Management in Accident & Emergency
Preoperative care
Anaesthetic management
Surgical management
Early postoperative management
Rehabilitation and discharge
Implementation and audit
Key messages for patients

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2003 Post traumatic coxa vara and femoral shortening

Case presentation of 19 yr old female 10 years after injury to her hip.During the years of follow up it was noticed that she was developing shortening of right femur along with coxa vara.
Treatment plan and outcome is presented along with some comments.

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2005 Hip Fracture eMedicine Sports

Hip fractures are classified as intracapsular, which includes femoral head and neck fractures, or extracapsular, which includes trochanteric, intertrochanteric, and subtrochanteric fractures. The location of the fracture and the amount of angulation and comminution play integral roles in the overall morbidity of the patient, as does the preexisting physical condition of the individual. Fractures of the proximal femur are extremely rare in young athletes and are usually caused by high-energy motor vehicle accidents or significant trauma during athletic activity. Other causes may be an underlying disease process such as Gaucher disease, fibrous dysplasia, or bone cyst. Identification and initiation of treatment is imperative in attempts to avoid complications, such as avascular necrosis (AVN). AVN is more common in patients in the pediatric and adolescent age groups. This outcome is due to the precarious nature of the blood supply to the subchondral region of the femoral head, which does not stabilize until years after skeletal maturity, after which collateral flow develops.
Synonyms and related keywords: femoral neck fracture, intracapsular hip fracture, hip stress fracture, femoral neck stress fracture, femoral stress fracture, Garden classification, Colonna classification, Evan classification, broken hip, fractured hip, cracked hip
Bhatti & Ertl 2005 Updated 2009

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2007 Algorithm May Help Predict 5-Year Risk for Hip Fracture in Women Medscape CME

December 3, 2007 — An algorithm composed of 11 readily available clinical variables offers a simple means to stratify the 5-year risk of hip fracture in postmenopausal women, according to the results of a study published in the November 28 issue of the Journal of the American Medical Association.
There were 11 factors associated with the increased risk for hip fracture within 5 years: age, self-reported health, weight, height, race or ethnicity, self-reported physical activity, history of fracture after age 54 years, parental hip fracture, current smoking, current use of corticosteroids, and treated diabetes.

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2007 One-Year Mortality Higher After Second vs First Hip Fracture Medscape

October 9, 2007 — One-year mortality after a second hip fracture (24.1%) was higher than 1-year mortality after a first hip fracture (15.9%), and the first hip fracture was an indicator for likelihood of a second hip fracture, according to results from the Framingham Heart Study reported in the October 8 issue of the Archives of Internal Medicine.

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2007 Validation of a 4-Item Score Predicting Hip Fracture and Mortality Risk Among Elderly Women

Annals of Family Medicine 5:48-56 (2007) Full Text
Daniel M. Albertsson, MD, Dan Mellström, MD, PhD, Christer Petersson, MD, PhD and Robert Eggertsen, MD, PhD
One in 4 Swedish women experiences a hip fracture, an event that has high concomitant morbidity and mortality. We developed and validated a clinical predictor of fracture and mortality risk, the Fracture and Mortality (FRAMO) Index.

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2008 Hip Fractures a tutorial for medical students

Most fractures through the femur neck and intratrochanteric regions occur in the elderly due to osteoporotic bone and or muscular incordination resulting in a fall. If a young patient suffers a fracture here it is often due to significant trauma and is often associated with other fractures and injuries.
The general medical condition must be assessed. These elderly patients are often dehydrated. Look out for other medical conditions, stroke and other hypertensive episodes as well as cardiac conditions may need to be diagnosed and managed.

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