Abstract
Fragility fractures of the hip are common, life-altering, and potentially threat-threatening injuries that cause significant disability and result in substantial costs to the United States healthcare system. With over 2 million osteoporotic hip fractures a year occurring in the United States, at a cost to the health care system exceeding US$20 billion per year, in-hospital complication rates of over 20%, and a 1-year mortality rate of 20$% to 40%, the prevention and management of hip fractures has attracted the attention of health care providers, payers, health policy makers, and patients. 1,2
Prevention and management of these complex injuries, which are often a marker of defective bone metabolism, have been shown to vary across practice settings based on factors other than patient or injury characteristics. 3 As a result of this variation in practice patterns, there are substantial variations in patient outcomes (including functional outcomes, morbidity, and mortality) and costs associated with the treatment of hip fractures. As such, there is considerable opportunity for health care providers to standardize their care of hip fracture patients in order to facilitate improved patient outcomes and reduced costs of care.
Over the past 4 decades, much has been learned about the pathophysiology and treatment of osteoporosis, the prevention of hip fractures, and the perioperative management of patients who have these debilitating injuries. However, the volume of published literature on this topic is staggering and far too voluminous for any clinician to review and synthesize by him or herself.
In this manuscript, Dr Mears and Dr Kates and colleagues have thoroughly summarized the latest research on hip fractures and provided the reader with valuable strategies to optimize the prevention and management of these devastating injuries. The information contained in this manuscript will prove invaluable to any health care provider or health system administrator who is involved in the prevention and management of fragility hip fractures.
As providers begin to gain a better understanding of the principles espoused in this article, it is our hope that they will be able to use this information to optimize the care they provide for elderly patients who are at risk of or who have osteoporotic hip fractures.