![]() ![]() ![]() Identify associated injuries and complications that affect immediate management (e.g., open fracture, fracture-dislocation, neurovascular injury).Early reduction is vital to avoid vascular compromise and sciatic nerve injury. Posterior hip dislocations account for 90% of hip dislocations and typically follow a dashboard injury. Hip fractures can be associated with hip dislocation. Thromboembolism and osteonecrosis of the femoral head are common severe complications. Older adults are at the highest risk of morbidity and mortality early involvement of geriatric care specialists is recommended for these patients. Nonoperative management may be considered for patients with severe comorbidities, although it is associated with a high mortality rate. Management typically includes multidisciplinary consultation, early pain management, IV fluid hydration, venous thromboembolism prophylaxis, and early surgical fixation. Comorbid conditions (e.g., anemia, acute kidney injury, delirium) are common with hip fractures. X-rays are usually diagnostic, but an MRI may be required to diagnose occult fractures or pathologic fractures. ![]() Clinical features include groin pain and deformity of the hip. Hip fractures in younger patients are usually caused by a high-energy impact (e.g., motor vehicle collision). Hip fractures in older adults are typically low-impact injuries and are often associated with osteoporosis. Hip fractures are classified as intracapsular (femoral head, femoral neck) or extracapsular (intertrochanteric, trochanteric, or subtrochanteric). ![]()
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