Hip fractures

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  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源

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最后审阅： 30 Nov 2025
最后更新： 21 Aug 2025

小结

定义

病史和体格检查

关键诊断因素

  • inability to bear weight
  • pain in affected leg/hip
  • pain with hip movement
完整详情

其他诊断因素

  • shortened and externally rotated leg
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危险因素

  • osteoporosis/osteopenia
  • age over 65 years
  • falls
  • low body mass index
  • female sex
  • high-energy trauma
  • medications
  • ethnicity
  • dementia
完整详情

诊断性检查

首要检查

  • plain x-rays
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需考虑的检查

  • MRI pelvis (without contrast)
  • CT pelvis (without contrast)
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治疗流程

急症处理

intracapsular (femoral neck) fracture

extracapsular (intertrochanteric) fracture

撰稿人

专家顾问

Herman Johal, MD, MPH, FRCSC

Orthopaedic Trauma Surgeon

Assistant Professor

Department of Surgery

McMaster University

Hamilton, Ontario

Canada

利益声明

HJ declares that he has no competing interests.

鸣谢

Dr Herman Johal would like to gratefully acknowledge Dr Bradley A. Petrisor and Dr Mohit Bhandari, the previous contributors to this topic.

利益声明

BAP and MB declare that they have no competing interests.

同行评议者

Marc F. Swiontkowski, MD

Professor

Department of Orthopedic Surgery

University of Minnesota

Minneapolis

MN

利益声明

MFS is Editor-in-Chief of the Journal of Bone and Joint Surgery.

Rudolf Poolman, MD, PhD

Consultant Orthopaedic Surgeon

Onze Lieve Vrouwe Gasthuis

Teaching Hospital with The University of Amsterdam

Department of Orthopaedic Surgery

Amsterdam

The Netherlands

利益声明

RP has been reimbursed by LINK for organizing education and research consultancy.

David Hackam, MD, PhD

Assistant Professor of Surgery

Children's Hospital of Pittsburgh

Pittsburgh

PA

利益声明

DH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline. December 2021 [internet publication].全文

American College of Radiology. ACR appropriateness criteria: acute hip pain. 2024 [internet publication].全文

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Hip fractures images

  • 鉴别诊断

    • Acetabular fracture
    • Pubic rami fracture
    • Femoral shaft or subtrochanteric femur fracture
    更多 鉴别诊断

  • 指南

    • ACR appropriateness criteria: acute hip pain
    • Perioperative management of antithrombotic therapy
    更多 指南

  • 患者教育信息

    Osteoporosis

    更多 患者教育信息
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