Best Practices in the Continuum of Care: Hip Fractures - uams 2025

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Initial management begins in the emergency department. Patients can lose up to 1 liter of blood from proximal femoral fractures, and thus fluid replacement and blood transfusion should be early considerations. Oral or intravenous analgesia should be administered, but achieving adequate pain control can be challenging.
Occult fractures are those that are not visible on x-ray and account for between 2% to 10% of hip fractures. [8] MRI has demonstrated 100% sensitivity and 93% to 100% specificity at diagnosing occult hip fractures and is, therefore, the gold standard.
Dont twist your hip inwards-keep knees and toes pointed upwards. Do not engage in activities which increase hip pain/swelling (prolonged periods of standing or walking) for the first 7-10 days following surgery. Avoid long periods of sitting (without leg elevated) or long distance traveling for 2 weeks.
Secure leg with stiff padding, such as wadded-up blankets or towels, held in place with heavy objects. Padding should extend above the hip and below the knee. If no materials are available, place one hand behind the persons knee and your other arm along the top of the thigh, so your hand is just below the pelvic area.
After a hip or pelvic fracture, your doctor may advise you not to put any weight on the affected hip for six weeks or more. This allows the bone to heal. Your doctor can provide crutches, a walker, a cane, or a wheelchair to help you get around.

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The guidelines include the following OT interventions: positioning and postural care, movements in bed, transferring in and out of bed, techniques for sitting, standing, walking, dressing, bathing, home environment and furniture advice, and preventing future falls.
Place the patient supine in a scissors position with the operative hip flexed and the contralateral hip extended. This allows lateral image intensifier views and helps prevent pelvic rotation around the perineal post when traction is applied.

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