Hip fracture treatment

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

For more detailed information please refer to the treatment section of the hip fracture chapter.

The first step in managing a patient with a fracture is to stabilize the patient if he/she is unstable due to blood loss, etc by giving them intravenous fluids and giving them some painkillers if the pain is severe. If only one bone is broken, using cast or brace might be a possible treatment option.

Non-surgical therapy

• The first step in managing a patient with a fracture is to stabilize the patient if he/she is unstable due to blood loss, etc by giving them intravenous fluids and giving them some painkillers if the pain is severe.
• In children, the usual plan is to attempt closed reduction followed by cast immobilization. In adults, treatment with immobilization in a molded long arm cast can be used in those rare occasions of a non-displaced fracture of the leg bone. If the fracture shifts in position, it may require surgery to put the bones back together.
• Rigid immobilization is suggested in preference to removable splints in nonoperative treatment for the management of Hip bone fractures.
• For all patients with Hip fractures, a post-reduction true lateral radiograph is suggested .
• Patients probably do not need to begin early leg motion routinely after stable fracture fixation.
• Adjuvant treatment of Hip fractures with vitamin C is suggested for the prevention of disproportionate pain.

For more detailed information please refer to the treatment section of the hip fracture chapter.

Complications of Non-surgical therapy

Failure of non-surgical therapy is common:

• Re-displacement to its original position even in a cast
• Stiffness
• Post traumatic osteoarthritis leading to wrist pain and loss of function
• Other risks specific to cast treatment include:
  • Compression of the swollen leg causing compartment syndrome
  • Reflex sympathetic dystrophy is a serious complication
  • Stiffness is universal following a prolonged period of immobilization and swelling