Geriatric Hip Fractures

The global burden of geriatric hip fractures is enormous. From both the patient's and physician’s perspective, the injury is complex. A hip fracture often changes a patient’s life and/or the life of the patient’s family permanently. From the physician’s perspective, care of geriatric hip fracture patients requires a multidisciplinary team, which is led by the surgeon and which includes internists and other subspecialists within internal medicine, anesthesiologists, nurses, operating room technicians, social workers, physical therapists, and rehabilitation center coordinators and staff. Nowhere in the orthopedic literature is there a text that guides care for these complex patients from injury through recovery. This text is the first to do so by organizing and synthesizing a large body of literature. Its main themes include pre-operative, operative, and post-operative care of the patient who sustains a geriatric hip fracture. Its main objective is to organize the current body of literature into a cohesive whole so that the busy orthopedic surgeon does not have to undertake a literature search each time he or she wants an answer to the myriad questions that characterize a patient’s injury, treatment, and recovery course. With regard to pedagogy, because orthopedic surgeons in training will utilize this book, and because the case study is the central pedagogical tool in the field of orthopedic surgery, this book includes case studies within each chapter, with the author’s preferred treatment and decision-making rationale for each case. Selected video supplements reinforce real-world application of knowledge. Practicing orthopedic surgeons, as well as orthopedic residents and fellows in training, will find Geriatric Hip Fractures: A Practical Approach a highly useful and informative resource.

This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.

This new open access edition supported by the Fragility Fracture Network aims at giving the widest possible dissemination on fragility fracture (especially hip fracture) management and notably in countries where this expertise is sorely needed. It has been extensively revised and updated by the experts of this network to provide a unique and reliable content in one single volume. Throughout the book, attention is given to the difficult question of how to provide best practice in countries where the discipline of geriatric medicine is not well established and resources for secondary prevention are scarce. The revised and updated chapters on the epidemiology of hip fractures, osteoporosis, sarcopenia, surgery, anaesthesia, medical management of frailty, peri-operative complications, rehabilitation and nursing are supplemented by six new chapters. These include an overview of the multidisciplinary approach to fragility fractures and new contributions on pre-hospital care, treatment in the emergency room, falls prevention, nutrition and systems for audit. The reader will have an exhaustive overview and will gain essential, practical knowledge on how best to manage fractures in elderly patients and how to develop clinical systems that do so reliably.

Fractures in the Elderly: A Guide to Practical Management provides geriatricians and other medical specialists who provide care for older adults with the vital guidance and most current data and opinions regarding the treatment of elderly patients who sustain a variety of fractures. It also provides orthopedic surgeons with the necessary information and most current data and opinions regarding assessment and management of geriatric conditions that predispose the elderly to fracture, perioperative complications and subsequent functional decline. Each chapter is both readable and appealing not only to geriatricians and orthopedic surgeons but to all clinicians that have contact with elderly patients who have sustained or are at high risk of sustaining a fracture. Emphasis is placed on the fact that although in some cases pre- and post-operative care in elderly fracture patient may proceed as it does in younger individuals, often there are considerations owing to functional status, pre-existing conditions, and age-related physiological declines that require specialized knowledge and alternative approaches. Developed by a group of renowned experts, Fractures in the Elderly: A Guide to Practical Management is a major addition to the literature and provides a wealth of specialized knowledge and approaches to care. It is an essential reference for all clinicians who care for older adults as well as fellows and residents in training.

This illustrated atlas provides a comprehensive monograph of femoral neck fractures. It has more than 800 representative figures, x-rays and drawings, and describes in detail non-invasive internal fixation.

​Newly revised and updated, this book provides geriatricians and orthopedic surgeons with the most vital tools to treat elderly patients who sustain a variety of fractures. The text uniquely encompass the etiologies of fracture in the elderly, perioperative management, the surgical treatment of common fractures in the elderly, as well as rehabilitation and prevention in the older patient. It focuses on the most current data and opinions regarding assessment and management of geriatric conditions that predispose the elderly to fracture, perioperative complications and subsequent functional decline. Unlike any other text, experts in both orthopedics and geriatrics review the content of each chapter for readability and appeal to his/her respective discipline, making this the physician’s ultimate guide to treating elderly patients with injuries. Fractures in the Elderly, Second Edition is a valuable resource for geriatricians, orthopedic surgeons, physiologists, and rehabilitation specialists.

This volume offers practical guidance on the management of fractures in elderly patients. The first part of the book addresses general issues such as epidemiology of fractures in the elderly, metabolic bone disease, principles and aims of fracture management, outcome assessment, preoperative medical evaluation, anaesthesia, postoperative complications, rehabilitation in the elderly, and management of multiply-injured patients. The second part covers fractures in specific anatomic regions. The work concludes with a discussion of the treatment of pathological fracturesm non-union and malunion, and osteomyelitis.

This issue of Clinics in Geriatric Medicine is centered on the management of the geriatric fragility fracture patient. This issue features expert clinical reviews on topics such as Principles of comanagement, Lean business model and implementation of a Geriatric Fracture Center, Preoperative optimization and risk assessment, Preoperative reversal and management of anticoagulation and antiplatelet agents, Classification and surgical approach to hip fractures for non-surgeons, Special anesthetic consideration for the fragility fracture patient, Non-surgical management and palliation of fragility fractures, and Management of post-operative complications including Delerium, Anemia, Venous thromboembolism, and Cardiovascular disease and volume management. Also included are articles on Transitions in care and rehabilitation, Osteoporosis related secondary fracture prevention, Post-operative assessment of falls risk and prevention, and Fragility fractures requiring special consideration.