Management of Acute Hip Fracture

Key Clinical PointsAcute Hip Fracture Hip fractures (categorized according to anatomical location as a femoral-neck fracture or an intertrochanteric or subtrochanteric fracture) can have a devastating effect on quality of life and function, with a high risk of death at 1 year. Femoral-neck fractures, if nondisplaced or in a young patient, are typically treated with internal fixation. For fractures at the base of the femoral neck (sometimes called basicervical fractures), displaced fractures, and those with a more vertically oriented fracture line, reoperation rates are lower when a sliding hip screw is used than when multiple cancellous screws are used. Approaches to displaced femoral-neck fractures remain controversial, but evidence currently favors arthroplasty over internal fixation, especially in persons 65 years of age or older. Unstable intertrochanteric and subtrochanteric fractures of the femur are treated with the use of intramedullary nails, whereas stable fractures of these types are typically ...