Summary
Definition
History and exam
Key diagnostic factors
- inability to bear weight
- pain in affected leg/hip
- pain with hip movement
Other diagnostic factors
- shortened and externally rotated leg
Risk factors
- osteoporosis/osteopenia
- age over 65 years
- falls
- low body mass index
- female sex
- high-energy trauma
- medications
- ethnicity
- dementia
Diagnostic tests
1st tests to order
- plain x-rays
Tests to consider
- MRI pelvis (without contrast)
- CT pelvis (without contrast)
Treatment algorithm
intracapsular (femoral neck) fracture
extracapsular (intertrochanteric) fracture
Contributors
Expert advisers
Herman Johal, MD, MPH, FRCSC
Orthopaedic Trauma Surgeon
Assistant Professor
Department of Surgery
McMaster University
Hamilton, Ontario
Canada
Declarações
HJ declares that he has no competing interests.
Agradecimentos
Dr Herman Johal would like to gratefully acknowledge Dr Bradley A. Petrisor and Dr Mohit Bhandari, the previous contributors to this topic.
Declarações
BAP and MB declare that they have no competing interests.
Revisores
Marc F. Swiontkowski, MD
Professor
Department of Orthopedic Surgery
University of Minnesota
Minneapolis
MN
Declarações
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
Declarações
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
Declarações
DH declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline. December 2021 [internet publication].Texto completo
American College of Radiology. ACR appropriateness criteria: acute hip pain. 2024 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Acetabular fracture
- Pubic rami fracture
- Femoral shaft or subtrochanteric femur fracture
Mais Diagnósticos diferenciaisDiretrizes
- ACR appropriateness criteria: acute hip pain
- Perioperative management of antithrombotic therapy
Mais DiretrizesFolhetos informativos para os pacientes
Osteoporosis
Mais Folhetos informativos para os pacientes
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