Fractures of the hip are common, often occurring in frail elderly patients, but also in younger fit healthy patients following trauma. They have a significant associated mortality and major social and financial implications to patients and health care providers. Many guidelines are available for the management of these patients, mostly recommending early surgery for the best outcomes. As a result, healthcare authorities now put pressure on surgical teams to ‘fast track’ patients with a fracture of the hip, often misquoting the available literature, which in itself can be confusing and even conflicting.
This paper has been written following an extensive review of the available literature. An attempt is made to clarify what is meant by early surgery (expeditious versus emergency), and we conclude with a personal view for the practical management of these patients of variable age, fitness and type of surgery performed within services that are often under considerable pressure of finance and available operating theatres and qualified staff.
Cite this article: Bone Joint J 2016;98-B:1573–81.
P. M. Lewis: Literature review, Analysis of data, Initial and final manuscript preparation.
J. P. Waddell: Article conception, Editing and final manuscript preparation.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by G. Scott and first proof edited by J. Scott.
- Received May 1, 2016.
- Accepted August 12, 2016.
- ©2016 The British Editorial Society of Bone & Joint Surgery