Related Experiment Video

Updated: Sep 21, 2025

Method and Instrumented Fixture for Femoral Fracture Testing in a Sideways Fall-on-the-Hip Position
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Proximal femur fractures in patients taking anti-coagulants: has anything changed?

Marilena Giannoudi1,2, Peter V Giannoudis3,4

  • 1Department of Cardiology, Bradford Teaching Hospitals NHS Trust, Bradford, UK.

EFORT Open Reviews
|May 31, 2022
PubMed

Insights

Managing hip fracture surgery (HFS) in elderly patients on blood thinners presents challenges. This review summarizes current evidence and recommendations for optimizing care for these complex cases.

Area of Science:

  • Geriatric Medicine
  • Orthopedic Surgery
  • Anesthesiology

Background:

  • Global hip fracture incidence is rising due to an aging population.
  • Elderly patients often have comorbidities and polypharmacy, including antiplatelet and anticoagulant use.
  • Managing blood-thinning medications around hip fracture surgery (HFS) poses clinical challenges.

Purpose of the Study:

  • To review current evidence on managing hip fracture surgery in patients taking blood-thinning medications.
  • To provide a summary of recommendations based on existing literature for clinical practice.

Main Methods:

  • Literature review of up-to-date evidence.
  • Synthesis of findings regarding anesthetic options, surgical timing, medication management, and reversal agents.

Main Results:

  • Evidence supports tailored approaches to anesthetic choices and surgical timing.
  • Guidelines exist for managing antiplatelet and anticoagulant cessation and resumption.
  • The use and indications for reversal agents in specific scenarios are outlined.

Conclusions:

  • Optimized management of blood-thinning agents is crucial for safe and effective hip fracture surgery.
  • Evidence-based recommendations can guide clinicians in perioperative care for these patients.
  • Further research may refine protocols for specific drug classes and patient populations.

Keywords:
anticoagulantsantiplateletship fractureproximal femur

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