Management of Hip Fractures and Related Injuries

Hip fractures represent a leading cause of morbidity and mortality among older adults worldwide. Effective management brings together rapid diagnosis, optimisation of medical status and timely surgical intervention. Fractures are typically classified as intracapsular (femoral neck) or extracapsular (trochanteric and subtrochanteric) and each subtype demands tailored fixation strategies or arthroplasty. Peri-operative care focuses on pain control, thromboprophylaxis, fluid balance and prevention of delirium through a coordinated orthogeriatric model. Surgical principles include achieving stable reduction, selecting appropriate implants to withstand physiological loads, and restoring alignment to facilitate early mobilisation. Advances in biomaterials and pharmacological augmentation seek to enhance bone–implant integration, particularly in osteoporotic bone, while finite-element studies guide surgical planning by identifying critical cortical supports. Postoperative rehabilitation and multidisciplinary follow-up aim to restore function, reduce complications and address long-term bone health through nutrition, physiotherapy and fall prevention strategies.

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Management of Hip Fractures and Related Injuries publication trend

The graph below shows the total number of articles in management of hip fractures and related injuries across all publications each year (not limited to Nature Index journals).

Technical terms

Intramedullary nail: A metal rod inserted into the central canal of the femur to stabilise extracapsular hip fractures.

Sliding hip screw (dynamic hip screw): A side-plate and screw device that allows controlled impaction of intertrochanteric fractures under load.

Bisphosphonate: A class of drugs that inhibit bone resorption, used to augment implant integration and treat osteoporosis.

Tip-apex distance (TAD): The sum of the distances from the tip of a lag screw or blade to the apex of the femoral head on radiographs, guiding optimal implant placement to reduce cut-out risk.

Anteromedial cortex: The front-inner portion of the trochanteric region, critical for load transfer and implant stability in extracapsular fractures.

References

1. Systemically administered zoledronic acid activates locally implanted synthetic hydroxyapatite particles enhancing peri-implant bone formation: A regenerative medicine approach to improve fracture fixation. Acta Biomaterialia (2024).
2. Relative instability ratios of bone wall defects in trochanteric hip fractures: A finite element analysis. Frontiers in Bioengineering and Biotechnology (2023).
3. Epidemiology, treatment and mortality of trochanteric and subtrochanteric hip fractures: data from the Swedish fracture register. BMC Musculoskeletal Disorders (2018).