The clinical significance of osteoporotic hip fracture surgery within 48 hours / 中华骨科杂志

ABSTRACT

Most osteoporotic hip fracture occurs in the elderly, with the aging of society, the incidence of such fracture is increasing. The majority of patients are now treated with surgery due to high mortality rate by non-surgical treatment. In the choice of time interval about "fracture-operation", several studies found that elderly with osteoporotic hip fracture had various co-morbidities and their physiological reserve function of the body were obviously reduced, which should be corrected before surgery. However, others believed that the co-morbidities are not aggravated within 2-3 days, using the "window period" to perform surgery could help patients to stand as early as possible after operation, which was beneficial not only to the control of co-morbidities, but also to the prevention of complications such as pneumonia, bedsore and muscular atrophy caused by lying on bed after fracture. Therefore, there are some different opinions on the operation time after fracture in the guidelines and consensus of various countries, including 36 hours, 48 hours, 120 hours and early operation. Among these time points, the idea of "surgery within 48 hours after fracture" has been incorporated into the National Medical Insurance Payment Conditions by the Israeli Ministry of Health, and has been included in the guidelines by the American Association of Orthopaedics, and has been reported in most clinical studies. This article reviewed the studies on different operation time after hip osteoporotic fracture, especially for the reasons, advantages and clinical management process of hip fracture surgery within 48 hours. In addition, these views were analyzed in order to provide reference and inspiration for clinical treatment and hospital management of hip osteoporotic fracture.