Abstract
The initial workup and diagnosis of geriatric hip fractures set the stage for the remainder of care for this multidisciplinary problem. A thorough history from the patient and caregivers provides information regarding a patient’s baseline demands and functional abilities, and it is important to know what medical comorbidities these patients have to ensure that they are appropriately medically managed during and after hospitalization. A detailed physical examination can help treating clinicians discover any additional fractures or injuries, and this is especially important in patients who are likely to sustain other low-energy fragility fractures. Appropriate radiographs include an anteroposterior (AP) view of the pelvis with a marker ball and full-length femur X-rays including an AP and lateral of the hip. Classifying the fracture allows the surgical team to properly communicate and plan for the procedure and have a more informed preoperative discussion with the patient and family members.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Seitz DP, Adunuri N, Gill SS, Rochon PA. Prevalence of dementia and cognitive impairment among older adults with hip fractures. J Am Med Dir Assoc. 2011;12(8):556–64. https://doi.org/10.1016/j.jamda.2010.12.001.
Cho YH, Byun YS, Jeong DG, Han IH, Park YB. Preoperative incidence of deep vein thrombosis after hip fractures in Korean. Clin Orthop Surg. 2015;7(3):298–302. https://doi.org/10.4055/cios.2015.7.3.298.
Feng L, Scherer SC, Tan BY, Chan G, Fong NP, Ng TP. Comorbid cognitive impairment and depression is a significant predictor of poor outcomes in hip fracture rehabilitation. Int Psychogeriatr. 2010;22(2):246–53. https://doi.org/10.1017/S1041610209991487.
Ko Y. Pre- and perioperative risk factors of post hip fracture surgery walking failure in the elderly. Geriatr Orthop Surg Rehabil. 2019;10. Published 2019 Jun 4 https://doi.org/10.1177/2151459319853463.
Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospective observational cohort study. BMJ. 2005;331(7529):1374.
Buecking B, Wack C, Oberkircher L, et al. Do concomitant fractures with hip fractures influence complication rate and functional outcome? Clin Orthop Relat Res. 2012;470:3596–606. https://doi.org/10.1007/s11999-012-2419-z.
Koval KJ, Oh CK, Egol KA. Does a traction-internal rotation radiograph help to better evaluate fractures of the proximal femur? Bull NYU Hosp Jt Dis. 2008;66(2):102–6.
Karakaş HM, Harma A. Femoral shaft bowing with age: a digital radiological study of Anatolian Caucasian adults. Diagn Interv Radiol. 2008;14(1):29–32.
Marchant MH Jr, et al. The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. JBJS. 2009;91(7):1621–9.
Ryan G, Nowak L, Melo L, et al. Anemia at presentation predicts acute mortality and need for readmission following geriatric hip fracture. JB JS Open Access. 2020;5(3):e20.00048. Published 2020 Sep 28. https://doi.org/10.2106/JBJS.OA.20.00048.
Morris R, Rethnam U, Russ B, Topliss C. Assessing the impact of fracture pattern on transfusion requirements in hip fractures. Eur J Trauma Emerg Surg. 2017;43(3):337–42.
Carson JL, Duff A, Berlin JA, Lawrence VA, Poses RM, Huber EC, et al. Perioperative blood transfusion and postoperative mortality. JAMA. 1998;279(3):199–205.
Kadar A, Chechik O, Steinberg E, Reider E, Sternheim A. Predicting the need for blood transfusion in patients with hip fractures. Int Orthop. 2013;37(4):693–700.
Bliemel C, Buecking B, Hack J, Aigner R, Eschbach DA, Ruchholtz S, Oberkircher L. Urinary tract infection in patients with hip fracture: an underestimated event? Geriatr Gerontol Int. 2017;17(12):2369–75. https://doi.org/10.1111/ggi.13077. Epub 2017 Jun 16.
Koval K, Zuckerman J. Hip fractures: a practical guide to management. New York: Springer; 2000.
Garden RS. Low-angle fixation in fractures of the femoral neck. J Bone Joint Surg Br. 1961;43:647–64.
Parker MJ, Dynan Y. Is Pauwels classification still valid? Injury. 1998;29(7):521–3.
Kim JO, Kim TH. Surgical treatment of femur intertrochanteric and subtrochanteric fracture. J Korean Hip Soc. 2010;22(1):1–12. https://doi.org/10.5371/jkhs.2010.22.1.1.
Sonawane DV. Classifications of intertrochanteric fractures and their clinical importance. Trauma Int. 2015;1(1):7–11.
Boskey AL, van der Meulen MCH. The duration and safety of osteoporosis treatment. Riverside: Springer; 2006.
Rayan F, Dodd M, Haddad FS. European validation of the Vancouver classification of periprosthetic proximal femoral fractures. J Bone Joint Surg. 2008;90(12):1576–9.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Levitsky, M.M., Shah, R.P., Neuwirth, A.L. (2021). Initial Workup, Diagnosis, and Fracture Classification for Geriatric Hip Fractures. In: Danford, N.C., Greisberg, J.K., Jobin, C.M., Rosenwasser, M.P., Walker, M.D. (eds) Geriatric Hip Fractures. Springer, Cham. https://doi.org/10.1007/978-3-030-78969-5_2
Download citation
DOI: https://doi.org/10.1007/978-3-030-78969-5_2
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-78968-8
Online ISBN: 978-3-030-78969-5
eBook Packages: MedicineMedicine (R0)