Hip fracture: physicians take more active role in patient care.

The typical hip fracture patient is a woman over the age of 65, and the primary risk factor is trabecular bone loss and diminished bone strength related to postmenopausal osteoporosis. Medical stabilization before surgery is an absolute requirement, and surgical repair may be delayed up to 7 days with no adverse effect on outcome. If the choice between conservative medical management or surgical repair is close, surgical repair almost always gives better results. Surgeons choose from among four types of hip repair surgery: pinning, placement of a nail, fixation, and arthroplasty. Potential postoperative complications include DVT and PE, pressure ulcers, delirium, UTIs, and wound infection. Early mobilization is imperative to the primary objectives of maximizing functional independence while preventing secondary complications.