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Hip Fracture

Calvin Luu, DO and Michael M Hanna, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Intracapsular

    • Femoral head, neck, subcapital, or transcervical

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

  • Extracapsula...

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...

TREATMENT

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

  • Wait times >24 hours for surgical repair associated with higher risk-adjusted like...

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...

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(...

SEE ALSO

Osteoporosis and Osteopenia 

CODES

ICD10

  • S72.092F Other fracture of head and neck of left femur, subsequent encounter for open fracture type IIIA, IIIB, or IIIC with routine healing

  • S72.092H Other fracture of head and neck of left ...

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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