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Complications of hip fractures: A review

World Journal of Orthopedics 2014年第4期5卷 402-411页

作者： pedro carpintero Jose Ramón Caeiro Rocío carpintero Angela Morales Samuel Silva Manuel Mesa Department of Orthopaedic University Hospital Reina Sofía 14004 Córdoba Spain Department of Orthopaedic University Hospital Santiago de Compostela 15006 La Corua Spain Department of Anesthesia University Hospital Reina Sofia 14004 Córdoba Spain Orthopaedic Department Hospital Valle de los Pedroches 14400 Pozoblanco Spain

Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections(alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum-a major contributor to fracture healing- in the femoral neck. In extracapsularfractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients.

关键词： Hip fracture Complications Morbidity Mortality Anesthesia

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