Hip Fracture Protocols

Early surgical intervention is thought to reduce in-hospital morbidity and mortality as well as short-term mortality rates for elderly patients with hip fractures. However, hip fractures are also thought to be a symptom of progressive decline in elderly patients with multiple medical comorbidities. A measured approach to medical optimization, which may preclude rapid surgical intervention, is often required to improve the patient’s ability to resume a prefracture standard of living. Of late, new models of geriatric hip-fracture care have emerged, most of which entail early involvement of geriatricians and interdisciplinary care pathways, while continuing to focus on rapid surgical treatment.

Key points

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Geriatric hip fracture is a common condition that is increasing in prevalence as the population ages.
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Geriatric patients with hip fracture often have multiple medical comorbidities that complicate their treatment and functional outcomes.
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Expedited surgical management of hip fractures in elderly patients is associated with improved outcomes and reduced early complications.
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Medical optimization of elderly patients with hip fractures before surgical management improves postoperative outcomes and long-term functional outcomes.
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Multiple models exist for care of geriatric patients with hip fracture.
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Early results indicate that protocol-driven, multidisciplinary care of geriatric patients with hip fractures appears to offer improved patient outcomes.