The American Academy of Orthopaedic Surgeons’ new guideline on the diagnosis and treatment of hip fractures in elderly patients targets problem areas such as postoperative delirium and pain management.
The clinical practice guideline, “Management of Hip Fractures in the Elderly,” addresses hip fractures in patients age 65 years and older and offers recommendations on issues such as the timing of surgery and the use of vitamin D.
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The AAOS also hopes the guideline will expose gaps in the body of research literature that should be addressed in future studies. The guideline has been endorsed by the American Geriatrics Society, the U.S. Bone and Joint Initiative, the Orthopaedic Trauma Association, the American Association of Clinical Endocrinologists, and the Hip Society.
The guideline’s recommendations include:
• Regional analgesia should be used to improve preoperative pain control in patients with hip fracture.
• MRI should be the advanced imaging of choice for diagnosis of presumed hip fracture not apparent on initial radiographs.
• Hip fracture surgery should be performed within 48 hours of admission.
• An interdisciplinary care program should be utilized for patients with mild to moderate dementia who have sustained a hip fracture.
• Supplemental vitamin D and calcium should be given to patients following hip fracture surgery.
• Patients should be evaluated and treated for osteoporosis after sustaining a hip fracture.
To read the entire guideline document, click here: www.aaos.org/research/guidelines/HipFxGuideline.pdf.