Fall Prevention – The Best Treatment for Hip Fractures

By: Chetan Deshpande, MD, FACS

Each year, hundreds of thousands of elderly patients will sustain a hip fracture which can be a life-changing event. These fractures result in significant pain, dysfunction, prolonged bed rest and substantial comorbidities. Often times, treatment protocols are focused on optimizing surgical management of these injuries. In recent years, multiple large studies have come out regarding optimized admission and treatment protocols that seek to fast-track patients with hip fractures through the emergency room, surgical suite, and post-hospital rehabilitation. However, as with many other disease processes often times we focus on acute treatment versus prevention which may be the most important way that we can reduce the impact of these severe injuries.

There are multiple strategies by which we can optimize fall prevention. Among the most effective is performing a home assessment to ensure that tripping hazards are minimized. These include removal of area rugs as needed, providing appropriate lighting in passageways and minimizing the need to ascend in descend staircases.

Patient-specific factors include ensuring that vision correction is appropriate. Stressing the utilization of ambulatory aid such as canes and walkers. One of the most important things as well as the continuous assessment and reassessment of maintenance medications such as blood pressure and thyroid medication which, if not properly adjusted can lead to dizziness and falls.

For those patients living in colder climates ensuring that sidewalks and driveways are free of ice and snow is critical as well. Although it is often a difficult conversation transitioning a patient to an assisted living facility or an inpatient nursing home either permanently or for a short period of time may be required.

As we go forward in trying to decrease the morbidity and mortality related to these common fractures a global prevention and treatment strategy is going to be required to have any meaningful impact. As such, it is critical that we have a multidisciplinary approach to managing these difficult injuries.

See Chetan Deshpande, MD, FACS speak at the GAPA 2020 Summer Conference in Sandestin, Fl.

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