injuries poisoning
Hip Fractures
Treatment of Hip Fractures
Usually open reduction with internal fixation (ORIF) Sometimes femoral head replacement or total hip replacement The vast majority of hip fractures are treated surgically to minimize the duration of pain and to avoid prolonged Bed Rest Effects , which is required after nonsurgical treatment and which increases the risk of serious complications (eg, deep venous thrombosis, pressure ulcers, deconditioning, pneumonia, death), particularly in older patients. Hip Surgery Rehabilitation is started as soon as possible after treatment of a hip fracture. Prophylactic anticoagulation may reduce the incidence of venous thrombosis after hip fracture. In the emergency department, older patients with hip fractures may be in pain while they are waiting for cardiac clearance for hip surgery. Increasingly, femoral nerve blocks and fascia iliaca compartment blocks are being used to control pain in older patients with isolated hip fractures. Pain can be controlled for up to 6 to 8 hours, and patients do not need opioids, which have more systemic adverse effects (eg, respiratory depression). Contraindications to regional nerve blocks include bleeding disorders and coagulopathies ( Treatment reference ). 