Perioperative aspects of hip fracture. Guidelines for intervention that will impact prevalence and outcome

The cost of treating osteoporosis-related diagnoses, over one half of which are hip fractures, is $5.2 billion per year. The incidence of hip fractures is rising, and it is the orthopedic surgeon who provides the definitive medical care to these patients. Factors associated with poor outcome in hip fractures include poor nutrition, impaired mental ability and mobility, age, male sex, and inadequate fluid resuscitation and medical stabilization prior to surgery. The energy requirements for fracturing the hip are low. Potential prophylactic interventions include fall prevention, hip protector devices, estrogen replacement therapy, and calcium and vitamin D supplementation.