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Orthogeriatrics pp 81–96Cite as

Hip Fracture: The Choice of Surgery

Part of the Practical Issues in Geriatrics book series (PIG)

Abstract

Hip fractures are operated with either prosthesis or various kinds of fracture fixation devices, with the aim of immediate mobilisation with full weight-bearing. Challenges are osteoporotic bone, bone vascularity, muscle-attachments, maintaining fracture reduction and slow fracture healing in the often-elderly population and, although reduced in recent years, still 5–20 % of patients need a reoperation, mainly depending on fracture type and choice of surgery. The extensive literature has created partial treatment consensus: Undisplaced femoral neck fractures seem adequately treated with parallel screws/pins or a sliding hip screw, while the displaced femoral neck fractures should be given a prosthesis in elderly patients. The stable trochanteric fractures are well treated with a sliding hip screw, while intramedullary nails seem superior for the unstable trochanteric and the sub-trochanteric fractures. During the last decades surgical guidelines have gained ground, along with national surgical quality standards and registries with possible identification of positive and negative outliers – which is expected to further improve the surgical outcome.

Keywords

  • Femoral Head
  • Femoral Neck Fracture
  • Intramedullary Nail
  • Trochanteric Fracture
  • Unstable Trochanteric Fracture

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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  1. Copenhagen University Hospital Hvidovre, Copenhagen, Denmark

    Henrik Palm

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  1. Henrik Palm
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Correspondence to Henrik Palm .

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Editors and Affiliations

  1. Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy

    Paolo Falaschi

  2. University College London , London, United Kingdom

    David R. Marsh

Additional information

This book-chapter is a shortened version of: Palm H (2016) An algorithm for hip fracture surgery. Doctor of Medical Science. Dissertation. Copenhagen University. ISBN 978-87-998922-0-4

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Palm, H. (2017). Hip Fracture: The Choice of Surgery. In: Falaschi, P., Marsh, D. (eds) Orthogeriatrics. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-319-43249-6_6

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  • DOI: https://doi.org/10.1007/978-3-319-43249-6_6

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