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Femoral neck fractures in elderly subjects: key principles of perioperative geriatric care

Published in N°273 - April 2018
Article viewed 44 times

Femoral neck fractures in elderly subjects: key principles of perioperative geriatric care

By J. BAY, L. MOISI in category UPDATE
EHPAD Edith Piaf - 50 rue des Bois - 75019 Paris

Femoral neck fractures are a major public health problem and predominantly affect an already fragile elderly population. The worldwide annual prevalence of femoral neck fractures is over 1.3 million.Despite progress in medicine, particularly in orthopaedic surgery and anaesthesia, the mortality rate remains high and is estimated to be between 15 and 30% in the year following the trauma.

Introduction

Femoral neck fractures are a major public health problem and predominantly affect an already fragile elderly population. The worldwide annual prevalence of femoral neck fractures is over 1.3 million.1 Despite progress in medicine, particularly in orthopaedic surgery and anaesthesia, the mortality rate remains high and is estimated to be between 15 and 30% in the year following the trauma.2 Moreover, these fractures often have devastating consequences in the mid- to long-term as regards functional capacity, with loss of autonomy leading to dependence, isolation and even institutionalisation. Within one year post-fracture, more than 40% of patients have not returned to their previous level of mobility, 35% are no longer able to walk without assistance and 20% are admitted to a nursing home.3 Furthermore, elderly patients are at a particularly high risk of developing immediate postoperative complications such as confusion, infections, organ failure or iatrogenic accidents.

For over fifty years, orthogeriatrics has developed significantly in order to provide the best possible care to elderly patients with hip fractures and to try to improve morbimortality. Different models have successively been considered, all based on close collaboration between orthopaedists and...

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