![]() Femoral neck fractures: current management. 2018 361:k1086.įlorschutz AV, Langford JR, Haidukewych GJ, et al. ![]() An approach to hip pain in a young adult. Lack of exercise is a major cause of chronic diseases. Assessing the impact of osteoporosis on the burden of hip fractures. Odén A, McCloskey EV, Johansson H, et al. Modifiable lifestyle factors associated with fragility hip fracture: a systematic review and meta-analysis. Mortensen SJ, Beeram I, Florance J, et al. Fall-related factors and risk of hip fracture: the EPIDOS prospective study. Magnetic resonance imaging for verifying hip fracture diagnosis why, when and how?. Management and treatment of femoral neck stress fractures in recreational runners: a report of four cases and review of the literature. Serum 25-hydroxyvitamin D concentrations and risk for hip fractures. Socioeconomic and living conditions are determinants of hip fracture incidence and age occurrence among community-dwelling elderly. A meta-analysis of previous fracture and subsequent fracture risk. Hip fracture: diagnosis, treatment, and secondary prevention. Early diagnosis of femoral neck stress fractures may decrease incidence of bilateral progression and surgical interventions: a case report and literature review. Effect of early surgery after hip fracture on mortality and complications: systematic review and meta-analysis. Simunovic N, Devereaux PJ, Sprague S, et al. Mortality and cause of death in hip fracture patients aged 65 or older: a population-based study. Panula J, Pihlajamäki H, Mattila VM, et al. The effect of hip fracture on mortality, hospitalization, and functional status: a prospective study. Heterogeneity of hip fracture: age, race, sex, and geographic patterns of femoral neck and trochanteric fractures among the US elderly. Karagas MR, Lu-Yao GL, Barrett JA, et al. Fragility fractures of the hip and femur: incidence and patient characteristics. Nieves JW, Bilezikian JP, Lane JM, et al. Hip fractures in the elderly: a world-wide projection. If not recognized and treated, these fractures can progress to complete and displaced fractures with high rates of nonunion and avascular necrosis.īrunner LC, Eshilian-Oates L, Kuo TY. Insufficiency fractures due to compromised bone strength occur without trauma in postmenopausal women. Femoral neck stress fractures typically occur in dancers 20 to 30 years of age, endurance athletes, and military service members, often because of training overload. Two less common hip fractures can also occur: femoral neck stress fractures and insufficiency fractures. Subsequent care focuses on prevention, with increased physical activity, home safety assessments, and minimizing polypharmacy. Early postoperative mobilization, followed by rehabilitation, improves outcomes. Physicians should be alert for the presence of delirium, which is a common postoperative complication. ![]() ![]() Medications for venous thromboembolism prophylaxis are also recommended. Pre- and postoperative antistaphylococcal antibiotics are given to prevent joint infection. Nonsurgical management can be considered for patients who are not good surgical candidates. Fractures are usually managed by surgery, with the approach based on fracture type and location spinal or general anesthesia can be used. Operative management within 24 to 48 hours of the fracture optimizes outcomes. Plain radiography is usually sufficient for diagnosis, but magnetic resonance imaging should be obtained if suspicion of fracture persists despite normal radiography. Hip fractures present with anterior groin pain, inability to bear weight, or a shortened, abducted, externally rotated limb. Modifiable risk factors include low body mass index, having osteoporosis, increased fall risk, medications that increase fall risk or decrease bone mineral density, and substance use. Nonmodifiable risk factors include lower socioeconomic status, older age, female sex, prior fracture, metabolic bone disease, and bony malignancy. Hip fractures are common causes of disability, with mortality rates reaching 30% at one year.
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