Geriatric Pts aren't Old Adults
- Fractures can occur with Low energy!
- Two anatomical location
- Femoral neck (blood supply threatened if displaced)
- Intertrochanteric ( capsule instertion)
X-rays needed for operative planning
- Ap pelvis, AP and lat ofhip, femur, knee
- MRI > CT, but CT is still much better than X-ray.
- Needs medical consult
- Improves operative outcome.
- Fragility fracture orderset required for Medicare payment!
How to Classify
- Open, Displaced, Comminuted (all yes/no questions)
- Displaced = unstable and hip replacement (total vs hemiarthroolasty depends on functional status)
- Non-displaced / stable (vagus deform)= screws
- Low rates of AVN, Infection, Out Of Bed quickly
- Mortality - 25% 1 yr mortality
- Function - you lose some fuctional status active vs community walker vs house walker vs bed bound