Hip Fracture Management

Updated: Jul 15

When a patient suffers a hip fracture, it is considered to be an acute emergency. Management of this severe injury requires a co-ordinated emergency approach to recognition and early treatment.


The mortality rate at one year following a hip fracture is approximately 25%. In addition, hip fractures result in significant morbidity. 50% of patients may not be able to walk independently and 25% not return to their own home after sustaining a hip fracture.


This would compare similarly with such conditions as severe sepsis, major trauma and stroke. Hence, it should be treated in the same manner as these time dependent conditions.


Delays to treatment are associated with further increased morbidity such as delirium and longer hospital stays.


Signs & Symptoms

  • Groin and hip pain following a fall

  • Unable to weight bear

  • Affected limb shortened and rotated (but if not evident, does not negate the presence of a fracture)

Pre-Alert

  • Tannoy call out - "ED Reg to Resus, Silver Trauma."

  • Resuscitation cubicle prepped in anticipation of arrival. Resus trolley allow X-rays to be performed.

  • Hip fracture proforma and methoxyflurane as analgesia available.

  • Inform ED X-ray of impending request for XR.

Arrival

  • Bed to bed transfers limited (ideally only one from ambulance to ED trolley)

  • If hip fracture is clinically suspected, X-rays should be ordered as soon as possible and radiology porter informed


Hip-Fracture-Management-SOP_02pdf

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