小结
定义
病史和体格检查
关键诊断因素
- história de queda ou trauma
- dor no quadril, virilha ou coxa afetados
- incapacidade de suportar peso ou mover o quadril
- perna encurtada e rotacionada externamente
- fatores de risco
危险因素
- osteoporose/osteopenia
- idade avançada
- quedas
- índice de massa corporal (IMC) baixo
- sexo feminino
- trauma de alta energia
- medicações
- demência
诊断性检查
首要检查
- radiografias simples
- hemograma completo
- ureia e eletrólitos
- glicose
- tipagem e reserva de sangue
- coagulograma
- eletrocardiograma (ECG)
需考虑的检查
- ressonância nuclear magnética (RNM) da pelve
- tomografia computadorizada (TC) da pelve
- cintilografia óssea com tecnécio
治疗流程
adequado para cirurgia
atualmente não é adequado para cirurgia: não está recebendo cuidados no final da vida
atualmente não é adequado para cirurgia: recebendo cuidados no final da vida
Pós-cirurgia
撰稿人
专家顾问
Michael Barrett, MBChB, FRCS (Tr & Orth), PG Cert Med Ed
Consultant Trauma and Orthopaedic Surgeon
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
利益声明
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
利益声明
ZL, BG, and HK declare that they have no competing interests.
同行评议者
Antony Johansen, MB BChir
Consultant Orthogeriatrician
University Hospital of Wales
Cardiff
UK
简介
AJ is clinical lead for the National Hip Fracture Database, Royal College of Physicians, London, UK.
利益声明
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.
参考文献
关键文献
National Institute for Health and Care Excellence. Hip fracture: management. January 2023 [internet publication].全文
Public Health Scotland. Scottish standards of care for hip fracture patients. May 2024 [internet publication].全文
British Orthopaedic Association. BOAST: the care of the older or frail orthopaedic trauma patient. May 2019 [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.
鉴别诊断
- Fratura do acetábulo
- Fratura nos ramos púbicos
- Fratura da haste femoral ou subtrocantérica do fêmur
更多 鉴别诊断指南
- Delirium: prevention, diagnosis and management in hospital and long-term care
- Hip fracture: management
更多 指南患者教育信息
Osteoporose: o que é?
Cirurgia de artroplastia do quadril
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