Canada position paper on hip fracture 

The management of patients with hip fracture includes evidence-based care throughout the patients journey from the emergency department to discharge. A position paper that addresses the challenges and outlines the evidence-based post hip fracture orthogeriatric care has been released in Canada.  

The paper is embedded in the three clinical pillars of FFN that address the needs of patients using a multidisciplinary orthogeriatric approach to care through acute care, rehabilitation and secondary prevention. The paper was developed using a comprehensive narrative review to identify and synthesize key articles on post hip fracture care for each of the sections and recommendations were developed.

The paper provides evidence recommendations on:

• Emergency department management
• Surgery within 48 hours
• Multimodal analgesia
• Surgery for different fracture types
• Rehabilitation including weight bearing as tolerated
• Post-operative management including delirium screening and management
• Fracture prevention including osteoporosis management  

Throughout the paper, recommendations consider secondary fracture prevention including the management of osteoporosis. Osteoporosis is a major disease state associated with significant morbidity, mortality, and health care costs. All patients who have had a hip fracture are high risk for osteoporosis and should be assessed and treated as appropriate to prevent a further fracture. However less than half of the individuals sustaining a low energy hip fracture are diagnosed and treated for the underlying condition.  

One of the authors, Dr. Jenny Thain, a geriatrician in London, Ontario says “This position paper was written to align with health care systems across Canada. Implementing the recommendations would help reduce recurrent fractures, improve the functional and mobility outcomes post hip fracture and reduce healthcare costs”.

Read the full text here!