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Thu, 3 Jan 2002 15:33:21 +0100

Has anyone got any references on this? Is there any evidenced based medicine on this topic?
 I'm sure we have all seen and dealt with such cases. There have been suggestions that in these cases an MRI scan is often useful. However most units appear to mobilze under supervision and then repeat the hip x-rays at 7-10 days or if pain suddenly increases. Since most patients will either get a Dynamic hip screw or a hemiarthroplasty, loss of position with weight bearing(in theory!)is unlikey to be a problem. Does anyone insert cannulated screws for elderly hip fractures? 
I would be interested in the opinion of others on the list regarding their views on the management of elderly hip fractures in terms of what fixation they use, for whom and why?> 
Many thanks
John Wood
London
> From: DocRickFry@aol.com
> Date: Wed 02/Jan/2002 14:35 CET
> To: trauma-list@trauma.org
> Subject: Re: Hip fractures
> 
> In a message dated 1/2/2002 8:26:10 AM Eastern Standard Time, 
> rowley@rowleys-host.compulink.co.uk writes:
> 
> 
> > I wonder if anyone knows the incidence of missed hip fracture on X-ray? For 
> > example, elderly patient attends and cannot 
> > walk following a fall on hip. X-ray, seen by competent specialist, shows no 
> > fracture. Patient fails to mobilise, and a 
> > second X-ray two days later, shows a fracture. 
> > 
> > 
> 
> Can easily happen--I have seen this on a number of occasions, usually with 
> subtle nondispaced fractures.  You must pay attention to your patient, and 
> continue x-rays, going to CT of the hip if necessary if clinical picture 
> suggests something more
> ERF
> 
> 

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Hip fractures