Hip fractures are the commonest reason for older adults to be admitted to hospital for emergency surgery — but the rest of their care isn’t about orthopaedics. Behind each fracture may lie frailty and a need for coordinated multidisciplinary teamwork. In this episode, we use hip fracture care as a lens to explore the wider challenges of caring for frail and older patients in hospital. From the early days of surgical defeatism to today’s orthogeriatric-led models and national audit, we ask: what can hip fracture care teach us about treatingolder adults more holistically?
Links:
‘Hip Fracture – the Cardiff approach’ on YouTube: https://www.youtube.com/playlist?list=PLH4P3rNfQEEswi7nEQQLTyyz7b2XVB4Ez
NICE Guideline: https://www.nice.org.uk/guidance/cg124
National Hip Fracture Database (NHFD): https://www.nhfd.co.uk/
BOA-BGS Blue Book: https://www.bgs.org.uk/sites/default/files/content/attachment/2018-05-02/Blue%20Book%20on%20fragility%20fracture%20care.pdf
Hip fractures in the elderly: a world-wide projection: Cooper et al. Osteoporosis Int. 1992. https://pubmed.ncbi.nlm.nih.gov/1421796/
Geriatric Orthopaedics. Devas BMJ 1974. https://www.bmj.com/content/1/5900/190
Effectiveness of geriatric rehabilitation after proximal femur fracture in the elderly: Kennie et al. BMJ 1988. https://pmc.ncbi.nlm.nih.gov/articles/PMC1834847/
Prospective randomised study of an orthopaedic geriatric in-patient service: Gilchrist et al. BMJ 1988. https://pubmed.ncbi.nlm.nih.gov/3143450/
Co-ordinated multidisciplinary approaches for inpatient rehabilitation of older patients with proximal femoral fractures: Cameron et al. Cochrane Database 2001 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000106/references
Questions and suggestions?
Email: Raihaan.Biju@wales.nhs.net
