A new future for hip fracture care--orthogeriatrician lead in an 'Acute' Hip Unit

Although surgery is the definitive treatment for almost all hip fractures, there is evidence that outcomes such as morbidity and mortality are not determined by the type of surgery but by comorbidities and postoperative complications. A team approach, especially the involvement of an orthogeriatrician in managing medical issues, has been shown to improve surgical outcomes and should be encouraged in hospitals worldwide. An Acute Hip Unit is able to address the complex challenging needs of a frail older high-risk population soon after admission, therefore minimising delays. An orthogeriatrician-led unit can deal with the preoperative and complex postoperative medical, social, ethical, physical, and mental health issues that are associated with 'hip fracture syndrome', providing structured standardised evidence-based care by trained staff. This could be the model of care for the future.