Summary
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- incapacidad para soportar peso
- dolor en la pierna/cadera afectada
- dolor con el movimiento de la cadera
Other diagnostic factors
- pierna acortada y rotada externamente
Risk factors
- osteoporosis/osteopenia
- mayores de 65 años
- caídas
- bajo índice de masa corporal
- sexo femenino
- traumatismo de alto impacto
- medicamentos
- grupo étnico
- demencia
Diagnostic tests
1st tests to order
- estudios radiográficos simples
Tests to consider
- IRM de pelvis (sin contraste)
- TC de pelvis (sin contraste)
- gammagrafía ósea con tecnecio
Treatment algorithm
fractura intracapsular (cuello femoral)
fractura extracapsular (intertrocantérica)
Contributors
Authors
Herman Johal, MD, MPH, FRCSC
Orthopaedic Trauma Surgeon
Assistant Professor
Department of Surgery
McMaster University
Hamilton, Ontario
Canada
Disclosures
HJ declares that he has no competing interests.
Acknowledgements
Dr Herman Johal would like to gratefully acknowledge Dr Bradley A. Petrisor and Dr Mohit Bhandari, the previous contributors to this topic.
Disclosures
BAP and MB declare that they have no competing interests.
Peer reviewers
Marc F. Swiontkowski, MD
Professor
Department of Orthopedic Surgery
University of Minnesota
Minneapolis
MN
Disclosures
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
Disclosures
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
Disclosures
DH declares that he has no competing interests.
References
Key articles
American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline. December 2021 [internet publication].Full text
American College of Radiology. ACR appropriateness criteria: acute hip pain - suspected fracture. 2018 [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
- Fractura acetabular
- Fractura de las ramas púbicas
- Fractura de la diáfisis femoral o subtrocantérica del fémur
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- Perioperative management of antithrombotic therapy
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