Hip fracture surgery in resource-limited environments: a systematic literature review

With life expectancies increasing worldwide, there is a concomitant rise in the incidence of fragility fractures. As such, low-income and lower-middle-income countries (LICs and LMICs) will be faced with increased incidences of hip fractures. The care of these fractures is adversely affected by various factors that include under-resourced healthcare systems and large socioeconomic disparities, which disproportionately affect patient care in these regions relative to high-income countries. The purpose of this study was to determine treatment trends and outcomes of hip fracture care in lesser resourced regions as reported in primary literature sources through a systematic review.

The article search was conducted on December 16, 2020, and April 14, 2022, in 3 databases: PubMed, Web of Science, and Embase. A search strategy unique to each database was developed with a research librarian using English search terms.

Studies were selected using DistillerSR systematic review software. Two rounds of screening were performed for inclusion: 1) title and abstract screening and 2) full-text screening. Two researchers independently reviewed all articles. No articles were excluded based on language.

The extracted information included country, study demographics and design, hip fracture location, treatment, and outcomes.

Of the 2533 initially identified abstracts, a total of 24 articles met the criteria for inclusion and were selected for final data extraction after full-text screening.

This systematic review demonstrates a paucity of research evaluating geriatric hip fractures in LICs and LMICs. Additional research is needed to better characterize the preferred treatment by fracture type and associated complications in resource-limited environments.