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Hip Fracture

Ashley M. Schinske, MD and Nida S. Awadallah, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Intracapsular

    • Femoral neck, subcapital, or transcervical

    • Intracapsular femoral neck fractures may disrupt blood supply, resulting in avascular necrosis (1).

  • Extracapsular

    • Intertrocha...

DIAGNOSIS

HISTORY

  • Mechanism of injury: High-energy falls and falls to the side increase the risk of hip fracture (2).

  • Pain in groin: If severe, fracture is likely displaced (1).

  • Pain may be referred to t...

TREATMENT

  • Urgent surgical repair if indicated; outcomes are best when done within 24 to 48 hours of injury (1)[C].

  • Focus initial care on adequate pain control and orthopedic consultation. Conservative ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Radiographs of the hip prior to discharge and every 6 weeks thereafter until healed after fixation procedure; after arthroplasty, follow-up x-ra...

REFERENCES

1
LeBlanc KE, Muncie HLJr, LeBlanc LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician.  2014;89(12):945–951. [View Abstract on OvidMedline]
2
Bateman L, Vu...

ADDITIONAL READING

  • Butt DA, Mamdani M, Austin PC, et al. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch Intern Med.  2012;172(22):1739–1744. [View Abstract ...

SEE ALSO

Osteoporosis and Osteopenia 

CODES

ICD10

  • S72.009A Fracture of unsp part of neck of unsp femur, init

  • S72.019A Unsp intracapsular fracture of unsp femur, init for clos fx

  • S72.036A Nondisplaced midcervical fracture of unsp femur, init

  • S...

CLINICAL PEARLS

  • Suspect a hip fracture in elderly patients presenting with a shortened, externally rotated leg, even with minimal trauma.

  • X-rays are usually sufficient to confirm diagnosis.

  • Treat hip fr...

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