Subtrochanteric Hip Fractures Guidelines

Updated: Aug 25, 2020
  • Author: Mark A Lee, MD; Chief Editor: William L Jaffe, MD  more...
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American Academy of Orthopaedic Surgeons: Hip Fractures in Elderly

In September 2014, the American Academy of Orthopaedic Surgeons released a clinical practice guideline for the management of hip fractures in elderly patients. [20]  Recommendations included the following:

  • Preoperative regional analgesia to reduce pain in hip fracture patients (strong recommendation)
  • Similar outcomes for general or spinal anesthesia for patients undergoing hip fracture surgery (strong recommendation)
  • Use of a cephalomedullary device to treat subtrochanteric or reverse obliquity fractures (strong recommendation)
  • Intensive physical therapy following hospital discharge to improve functional outcomes (strong recommendation)
  • Blood transfusion threshold no higher than 8 g/dL in asymptomatic patients who have undergone hip fracture surgery (strong recommendation)
  • Interdisciplinary care program in mildly to moderately demented patients with hip fractures to improve functional outcomes (strong recommendation)
  • Multimodal analgesia after hip fracture surgery (strong recommendation)
  • Hip fracture surgery within 48 hours of hospital admission (moderately strong recommendation)
  • Prophylaxis for venous thromboembolism in hip fracture patients (moderately strong recommendation)
  • An osteoporosis evaluation, as well as vitamin D and calcium supplements, for patients following a hip fracture (moderately strong recommendations)