Tuesday, August 2, 2011

Geriatric Hip Fracture

An active 89 year old female presented to our Emergency Department following a fall complaining of left hip pain and an inability to walk. Radiographs revealed an intertrochanteric hip fracture.

She was admitted to the hospital and evaluated by the internal medicine team. She was cleared for surgery and on the following day she was taken to the operating room for closed reduction and internal fixation with a Dynamic Hip Screw (DHS).

Following the surgery, she was allowed to put weight on her leg as she tolerated. Her immediate postoperative course was uncomplicated. Her xrays at six weeks demonstrate good alignment and evidence of early healing.

Unfortunately, just before her three month follow up appointment, she fell again and sustained a right hip fracture.

Again, the patient was evaluated and co-managed by the medical team. This fracture was treated with a closed reduction and stabilized with a medullary hip screw. We chose to use this implant due to concerns that the fracture extended distally. For fractures that extend into the subtrochanteric region, a medullary implant is preferred over the DHS. At 2 months, the following xrays were obtained.

The patient is now almost 3 years out from her second surgery and is doing well. She uses a walker to ambulate and lives in an assisted living community. When caring for geriatric patients with hip fractures it is important to provide a quality operation, but also a team approach as to optimize patient outcome.

Authored By: Lisa A. Taitsman, M.D. 

1 comment:

  1. Thanks for sharing this information. This was really useful and informative.

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