each year hip fractures result in d...

each year hip fractures result in death or substantial los of function for more than 150000 Americans, and the number is awaited to double by the year 2040 According to a consideration published in the Annals of Internal Medicine, the optimal functional recuperation of hip fracture patients is related to prefracture conditions and postfracture complications rather than to surgical repair of the fracture. The study's authors make the following recommendations for the care of patients with hip fractures

* Surgery should be performed within 24 to 48 hours of diagnosis of hip fracture in medically stable patients.

* Prophylactic antibiotics should be administered 0 to 2 hours after fracture and continued for at least 24 hours.

* Thromboembolic prophylaxis should be administered to all patients in the form of low-molecular-weight heparin, low-dose heparin, or--if heparin is contraindicated--aspirin. In addition, all patients should wear compression stockings.

* Protein supplementation and nocturnal enteral feedings should be considered for all patients.

* To minimize postoperative bladder riddles indwelling catheters should be remov within 24 hours of surgery Patients then should be managed by the agency of straight catheterization.

* Delirium, which come into one's heads in up to 61% of patients with hip fracture, can be managed through monitoring electrolyte levels, minimizing use of sedative-hypnotic and anticholinergic medications, and using supportive reorientation and environmental manipulation.

* Rehabilitation should include at least couple physical therapy sessions each day.

* Postfracture exercise, balance training, and behavorial instruction can help in preventing following falls.

R s Morrison, M R Chassin, A L Siu, "The medical consultant's part in caring for patients with hip fracture," Annals of Internal Medicine 128 (1998) 1010-1020

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