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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
ORTHOPEDIC TRAUMA UPDATE PARTE II
Minerva Ortopedica e Traumatologica 2009 December;60(6):541-54
Intracapsular femoral neck fractures in elderly patients
Streubel P. N., Gardner M. J., Ricci W. M.
Orthopedic Trauma Service, Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, MO, USA
Hip fractures are one of the leading causes for mortality and loss of quality of life in the elderly population. A large body of literature has been published over the last 30 years on the management of intracapsular hip fractures in this population. Surgical treatment is the preferred method of management, with internal fixation being indicated in most non-displaced and hip arthroplasty in most displaced fractures. The high prevalence of comorbidities in patients with hip fractures requires an interdisciplinary approach to reduce the risk of perioperative complications. Regional analgesia may improve pain management and reduce complications related to opioid medication, while frequently present malnutrition may be corrected with nutritional consultation and nutritional supplementation. Perioperative delirium should be actively monitored and may warrant early geriatric specialist consultation. In order to complete multimodal care, fall prevention programs and initiation of osteoporotic treatment are required.