Fractura de cadera
Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- antecedentes de caídas o traumatismos
- dolor en la cadera, la ingle o el muslo afectados
- incapacidad para soportar peso o mover la cadera
- pierna acortada y rotada externamente
- Factores de riesgo
Fatores de risco
- osteoporosis/osteopenia
- edad avanzada
- caídas
- índice de masa corporal (IMC) bajo
- sexo femenino
- traumatismo de alto impacto
- medicamentos
- demencia
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- Radiografías simples
- hemograma completo
- urea y electrolitos
- glucosa
- agrupe y guarde
- cribado de coagulación
- electrocardiograma (ECG)
Investigações a serem consideradas
- resonancia magnética (IRM) de pelvis
- tomografía computarizada (TC) de pelvis
- gammagrafía ósea con tecnecio
Algoritmo de tratamento
apto para cirugía
Actualmente no es apto para la cirugía: no recibe atención al final de la vida
Actualmente no es apto para la cirugía: reciba atención al final de la vida
Postoperatorio
Colaboradores
Consultores especialistas
Michael Barrett, MBChB, FRCS (Tr & Orth), PG Cert Med Ed
Consultant Trauma and Orthopaedic Surgeon
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
Declarações
MB is a director of Orthohub.xyz, an online education platform for orthopaedic surgeons. Orthohub.xyz receives sponsorship from the healthcare industry.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:
Zoe Little
ST6 in Trauma and Orthopaedics
Epsom and St Helier University Hospitals
Epsom
UK
Brett Griffiths
Specialist Registrar
Norfolk and Norwich University Hospitals
Norwich
UK
Hiba Khan
ST4 in Trauma and Orthopaedics
Croydon University Hospital
London
UK
Declarações
ZL, BG, and HK declare that they have no competing interests.
Revisores
Antony Johansen, MB BChir
Consultant Orthogeriatrician
University Hospital of Wales
Cardiff
UK
Biography
AJ is clinical lead for the National Hip Fracture Database, Royal College of Physicians, London, UK.
Disclosures
AJ has been a co-applicant or collaborator in successful applications for non-commercial grants from the NIHR Health Technology Assessment Programme, Physiotherapy Research Foundation, and Versus Arthritis.
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.
References
Key articles
National Institute for Health and Care Excellence. Hip fracture: management. January 2023 [internet publication].Full text
Public Health Scotland. Scottish standards of care for hip fracture patients. May 2024 [internet publication].Full text
British Orthopaedic Association. BOAST: the care of the older or frail orthopaedic trauma patient. May 2019 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
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