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Evidence‐based guidelines for the management of hip fractures in older persons: an update

2010; Wiley; Volume: 192; Issue: 1 Linguagem: Inglês

10.5694/j.1326-5377.2010.tb03400.x

1326-5377

Jenson Mak, Ian D. Cameron, Lyn March,

Cardiac, Anesthesia and Surgical Outcomes

Medical Journal of AustraliaVolume 192, Issue 1 p. 37-41 Review Evidence-based guidelines for the management of hip fractures in older persons: an update Jenson C S Mak MB BS, FRACP, FAFRM(RACP), Corresponding Author Jenson C S Mak MB BS, FRACP, FAFRM(RACP) Rehabilitation Medicine Physician; Geriatrician and Orthogeriatrician; and Clinical Research Fellow jenson.mak@gmail.com Sacred Heart Rehabilitation Service, St Vincent's Hospital, Sydney, NSW. Department of Geriatric Medicine, Gosford Hospital, Gosford, NSW. Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW.Correspondence: jenson.mak@gmail.comSearch for more papers by this authorIan D Cameron MB BS, PhD, FAFRM(RACP), Ian D Cameron MB BS, PhD, FAFRM(RACP) Rehabilitation Medicine Physician and Head Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW.Search for more papers by this authorLyn M March MB BS, PhD, FRACP, Lyn M March MB BS, PhD, FRACP Rheumatologist Institute of Bone and Joint Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW.Search for more papers by this author Jenson C S Mak MB BS, FRACP, FAFRM(RACP), Corresponding Author Jenson C S Mak MB BS, FRACP, FAFRM(RACP) Rehabilitation Medicine Physician; Geriatrician and Orthogeriatrician; and Clinical Research Fellow jenson.mak@gmail.com Sacred Heart Rehabilitation Service, St Vincent's Hospital, Sydney, NSW. Department of Geriatric Medicine, Gosford Hospital, Gosford, NSW. Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW.Correspondence: jenson.mak@gmail.comSearch for more papers by this authorIan D Cameron MB BS, PhD, FAFRM(RACP), Ian D Cameron MB BS, PhD, FAFRM(RACP) Rehabilitation Medicine Physician and Head Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW.Search for more papers by this authorLyn M March MB BS, PhD, FRACP, Lyn M March MB BS, PhD, FRACP Rheumatologist Institute of Bone and Joint Research, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW.Search for more papers by this author First published: 04 January 2010 https://doi.org/10.5694/j.1326-5377.2010.tb03400.xCitations: 131Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract Objective: To update evidence-based guidelines for the treatment of proximal femoral fractures published in the Journal in 2003. Data sources: Systematic search of MEDLINE, CINAHL and EMBASE for articles published from October 2001 to June 2008, and the Cochrane Database of Systematic Reviews (most recent issue searched — Issue 2, 2008). Study selection: Randomised controlled trials and meta-analyses of all aspects of acute-care hospital treatment and rehabilitation for proximal femoral fractures among participants aged 50 years or older with proximal femoral fractures not associated with metastatic disease or multiple trauma. Data extraction: All studies were reviewed independently by two assessors, who recorded individual study results, and an assessment of study quality and treatment conclusions was made according to Cochrane Collaboration protocols. If necessary, a third review was performed to reach consensus. Results: 128 new studies were identified and 81 met our inclusion criteria. Recommendations for time to surgery, thromboprophylaxis, anaesthesia, analgesia, prophylactic antibiotics, surgical fixation of fractures, nutritional status, mobilisation and rehabilitation have been updated. Also, recommendations regarding surgical wound closure, management of postoperative delirium, osteoporosis treatment and hip protectors have been added. The guidelines include the current National Health and Medical Research Council grades of recommendations for clinical guidelines. Conclusions: Significant changes in recommendations have been made, particularly in relation to surgery, rehabilitation and tertiary prevention. Hip fracture should be treated according to the most up-to-date evidence to achieve the best possible outcomes and optimal use of limited resources. Citing Literature Volume192, Issue1January 2010Pages 37-41 RelatedInformation