Femoral Fractures - Related Resources

Cochrane reviews

No clear conclusions can be made on the choice of implant for internal fixation of intracapsular fractures Internal Fixation Implants for Intracapsular Hip Fractures in Adults.
Intermittent pneumatic compression may reduce the risk of deep vein thrombosis in postoperative patients Intermittent Pneumatic Compression and Deep Vein Thrombosis Prevention.
Multidisciplinary inpatient rehabilitation for older people after hip fracture surgery may improve activities of daily living and mobility in the short term but does probably not improve overall outcome or reduce mortality Multidisciplinary Rehabilitation for Older People with Hip Fractures.
Oral protein and energy feeds may have some beneficial effects during hip fracture aftercare but overall the evidence for the effectiveness of nutritional supplementation is weak Nutritional Supplementation for Hip Fracture Aftercare in the Elderly.
In the treatment of a hip fracture with arthroplasty, cementing the prosthesis in place may reduce post-operative pain and lead to better mobility as compared to uncemented prosthesis Arthroplasties for Proximal Femoral Fractures in Adults.
Operative management of extracapsular femoral fractures may reduce the length of hospital stay and improve rehabilitation as compared to conservative management by traction Conservative Versus Operative Treatment for Extracapsular Hip Fractures.
A programme of proactive geriatric consultation may reduce delirium incidence and severity in patients undergoing surgery for hip fracture Interventions for Preventing Delirium in Hospitalised Patients.
Traction prior to surgery for a hip fracture may not provide any benefit in terms of relief of pain or success of fracture reduction Pre-Operative Traction for Fractures of the Proximal Femur in Adults.
Internal fixation appears to be associated with less initial operative trauma but with an increased risk of re-operation on the hip as compared with arthroplasty in the treatment intracapsular femoral fractures in adults. Both procedures have their own inherent complications Internal Fixation Versus Arthroplasty for Intracapsular Proximal Femoral Fractures in Adults.
There is insufficient evidence from randomised trials to determine whether replacement arthroplasty has any advantage over internal fixation for extracapsular hip fractures Replacement Arthroplasty Versus Internal Fixation for Extracapsular Hip Fractures in Adults.
The sliding hip screw may be preferable to fixed nail plates for fixing extracapsular hip fracture in adults Extramedullary Fixation Implants for Extracapsular Hip Fractures.
The use of nerve blocks inserted either before or at the time of surgery of hip fracture appears to reduce the degree of pain, the need for parenteral analgesia, and the risk of cardiac complications Nerve Blocks (Subcostal, Lateral Cutaneous, Femoral, Triple, Psoas) for Hip Fractures.

Other evidence summaries

Threaded acetabular cups may have a higher failure rate than cemented or porous in-growth cups Type of Acetabular Cup for Total Hip Replacement.
The greatest volume of evidence is available for the Charnley prosthesis. The use of more expensive (cementless) prostheses is hard to justify on current evidence Outcomes and Cost-Effectiveness of Primary Total Hip Replacement with Different Prostheses.
Arthroplasty may be associated with fewer secondary major operations than internal fixation in the treatment of displaced fractures of the femoral neck Outcomes after Displaced Fractures of the Femoral Neck.
Screws appear to be preferable to smooth pins for internal fixation of femoral neck fractures Choice of Implant for Internal Fixation of Femoral Neck Fractures.
Geriatric hip fracture programmes and early supported discharge may shorten the average length of hospital stay and increase rates of return to previous residential status Geriatric Rehabilitation Following Fractures in Older People.

Literature

Miyamoto RG, Kaplan KM, Levine BR, Egol KA, Zuckerman JD. Surgical management of hip fractures: an evidence-based review of the literature. I: femoral neck fractures. J Am Acad Orthop Surg 2008 Oct;16(10):596-607. [PubMed]
Kaplan K, Miyamoto R, Levine BR, Egol KA, Zuckerman JD. Surgical management of hip fractures: an evidence-based review of the literature. II: intertrochanteric fractures. J Am Acad Orthop Surg 2008 Nov;16(11):665-73. [PubMed]
Kannus P, Parkkari J, Niemi S, Pasanen M, Palvanen M, Järvinen M, Vuori I. Prevention of hip fracture in elderly people with use of a hip protector. N Engl J Med 2000 Nov 23;343(21):1506-13. [PubMed]

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Femoral Fractures - Related Resources

Cochrane reviews

Other evidence summaries

Literature