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Approach to patients with hip fracture and concurrent stroke
Jing Wei Lim1, Guat Cheng Ang2
1Geriatric Medicine, Changi General Hospital, Singapore jingwei.lim@mohh.com.sg.
BMJ Case Reports
|February 24, 2021
Summary
This case study highlights surgical hip fracture repair in a patient with an acute stroke. Early intervention and multidisciplinary care can lead to good functional outcomes, even with increased risks.
Area of Science:
- Geriatric Medicine
- Neurology
- Orthopedic Surgery
Background:
- Hip fractures are common in the elderly, often requiring surgical intervention.
- Acute stroke presents significant perioperative risks for surgical patients.
- Optimal management strategies for concomitant hip fracture and stroke are not well-defined.
Observation:
- A 70-year-old male presented with both a hip fracture and an acute stroke.
- The patient underwent surgical repair of the hip fracture despite stroke-related risks.
- Post-surgery, the patient experienced good functional recovery following rehabilitation.
Findings:
- No established guidelines exist for selecting patients with concurrent hip fracture and stroke for surgery.
- There is no consensus on the optimal timing for surgical hip repair in stroke patients.
- Patient factors like functional status, comorbidities, and stroke severity influence surgical candidacy.
Implications:
- Multidisciplinary orthogeriatric care teams may improve decision-making for these complex cases.
- Surgical repair of hip fractures in select stroke patients can yield positive functional outcomes.
- Further research is needed to establish clear guidelines for managing concomitant hip fractures and strokes.
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