Hip fractures are the commonest reason for older adults to be admitted to hospital for emergency surgery — but the rest of their care isn’t about orthopaedics. Behind each fracture may lie frailty and a need for coordinated multidisciplinary teamwork. In this episode, we use hip fracture care as a lens to explore the wider challenges of caring for frail and older patients in hospital. From the early days of surgical defeatism to today’s orthogeriatric-led models and national audit, we ask: what can hip fracture care teach us about treatingolder adults more holistically? 

Links:

‘Hip Fracture – the Cardiff approach’ on YouTube: https://www.youtube.com/playlist?list=PLH4P3rNfQEEswi7nEQQLTyyz7b2XVB4Ez

NICE Guideline: ⁠https://www.nice.org.uk/guidance/cg124⁠

National Hip Fracture Database (NHFD): ⁠https://www.nhfd.co.uk/⁠

BOA-BGS Blue Book:⁠ https://www.bgs.org.uk/sites/default/files/content/attachment/2018-05-02/Blue%20Book%20on%20fragility%20fracture%20care.pdf⁠

Hip fractures in the elderly: a world-wide projection: Cooper et al. Osteoporosis Int. 1992. https://pubmed.ncbi.nlm.nih.gov/1421796/

Geriatric Orthopaedics. Devas BMJ 1974. https://www.bmj.com/content/1/5900/190

Effectiveness of geriatric rehabilitation after proximal femur fracture in the elderly: Kennie et al. BMJ 1988. https://pmc.ncbi.nlm.nih.gov/articles/PMC1834847/

 Prospective randomised study of an orthopaedic geriatric in-patient service: Gilchrist et al. BMJ 1988. ⁠ https://pubmed.ncbi.nlm.nih.gov/3143450/

Co-ordinated multidisciplinary approaches for inpatient rehabilitation of older patients with proximal femoral fractures: Cameron et al. Cochrane Database 2001 https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000106/references

Questions and suggestions?

Email: Raihaan.Biju@wales.nhs.net