Treatment of hip fractures in the elderly--the decision process

A fractured hip in an elderly person is usually treated by performing one of various surgical procedures. There are also choices in postoperative routines involving weight-bearing status, blood transfusions, anticoagulation measures and pain control. Several factors influence the selection of treatment and postoperative routine. Among them are the preoperative health status and mobility of the patient, the type of fracture and the quality of the bone. The relationship between these factors and the various treatments is explored in an effort to show how and why an orthopedist decides on a particular treatment routine. Understanding these relationships should enable the nonorthopedic members of the hip fracture team to participate more effectively in the care of the patient.