Prevention and Management of Hip Fractures
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More About This Title Prevention and Management of Hip Fractures


Fractured neck of femur is a condition greatly feared by many elderly people. In my work as a ward sister and specialist nurse I have come to recognize the unique challenges associated with caring for patients with femoral neck fracture. Their journey of care is a complex one, which needs to be well managed from the moment they arrive in the Accident and Emergency department until their discharge from the acute environment, through the rehabilitation process and their eventual discharge. With improved knowledge and a commitment to preventative strategies, we can do much to help reduce the incidence of hip fracture in the future.

The aim of this book is to develop the reader's knowledge and skills in both theory and practice and to encourage readers to apply this knowledge when caring for people who have fractured their hip. The book emphasizes the importance of collaborative working to promote effective rehabilitation and improve outcomes.

This book will serve as a comprehensive resource for any nurse or allied health professional whose working life brings them into contact with people who have sustained a femoral neck fracture, and assist nurses them to meet the complex needs of this client group.


Elizabeth Onslow, Elderly Care Nurse Specialist, Trauma and Orthopaedic Directorate, Southampton General Hospital, UK





Chapter 1. Epidemiology, morbidity and mortality.

Sex and race.

Residential factors.

Anthropometric factors.

Bone geometry.

Gynaecological and familial risk factors.

Environmental factors.

Lifestyle factors.

Mortality and morbidity.

Chapter 2. Osteoporosis.


Change in bone mass through life.

Bone remodelling.


Bone quality.

Risk factor.

Finding those patients at risk.

Rationale for consideration for bone densitometry.

Diagnosing osteoporosis.

Measuring bone density.

Bone markers.

Bone health promotion.

Dietary factors and exercise.


The role of physiotherapy in osteoporosi.


Hip protectors.

Other guidelines and information.

Chapter 3. Falls in older people.

Environmental risk factors.

Extrinsic factors.

Intrinsic factors.

Preventing a 'long lie.

Research and cooperation.

Falls in the hospital environment.


Chapter 4. Anatomy and physiology of the hip joint.

Anatomy of the hip join.

Fracture classification.

Conservative and non-operative management.


Chapter 5. Assessment.

Pressure sore risk.

Nutrition and hydration.




Cognitive function.

Chapter 6. Journey of care.

Accident and emergency department.

Preoperative management.

Thromboembolic prophylaxis.

Consent for surgery.

Preoperative fasting.

Operative stage.

Early postoperative management.

Further postoperative management and care.

Chapter 7. Standardizing and streamlining hip fracture care.

Fast track admission from A&E .

Clerking pro-forma.

Review by orthogeriatric liaison team.

Anaesthesia for hip fracture patients.

Traffic light system.

Care pathway.


Appendix: A-Z of anaesthesia for hip fracture patients.

Chapter 8. Developing an orthogeriatric liaison service.

Establishing the need for a service.

Members of the orthogeriatric liaison team.

Service activities and impact on patient care.

Barriers to developing and maintaining a service.

Chapter 9. Rehabilitation and discharge planning.

Team working.

Team building.

Rehabilitation and discharge planning.

Discharge planning.

Functional ability.

Mental state.

Social circumstances.

Chapter 10. Impact of policy on the care of the patient with a hip fracture.

Essence of Care.

National Service Framework.


Chapter 11. Future Developments.


Investigation of the principle cause of the fall.

Implementation of falls prevention strategies.

Useful websites.