© 2016 American Academy of Orthopaedic Surgeons 1 KEYWORDS: hip fracture trauma evidence-based medicine Dr. Suk or an immediate family member serves as a paid consultant to Acumed, DJ Orthopaedics, Styrker, and Synthes and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association, and AO International. INTRODUCTION Hip fractures are becoming increasingly common, given the rapidly increasing elderly population. Often, the elderly demographic, which is most at risk for prox- imal femur fractures, is complex, with a combination of osteoporosis and/or mul- tiple medical comorbidities and has a 1-year mortality rate of 25% to 30% after hip fracture.1 Optimizing medical management, rather than simply focusing on fracture fixation, is at the forefront of hip fracture management. To avoid complications asso- ciated with prolonged immobilization, early mobilization is still the main treatment goal this typically involves surgical intervention. In-house costs for treating proxi- mal femur fractures are estimated to be $9 billion, with overall costs in excess of $20 billion. By 2040, the overall cost of treatment is estimated to be $240 billion.1-3 In addition to substantial overall costs and substantial mortality rates, 25% of patients who were functionally independent before fracture remained in a nursing home or assisted living 1 year after hip fracture. Sixty percent require assistance in one or more activities of daily living and 40% lose at least one level of ambulatory independence.4,5 To streamline care and address the increasing burden on the health care system, integrated multidisciplinary care teams are becoming increasingly com- mon in the perioperative management of proximal femur fractures. 1 PERIOPERATIVE TREATMENT OF THE HIP FRACTURE PATIENT Michael Suk, MD, JD, MPH
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