perform surgery on the day of, or the day after, admission
identify and treat correctable comorbidities immediately so that surgery is not delayed by:
anaemia
anticoagulation
volume depletion
electrolyte imbalance
uncontrolled diabetes
uncontrolled heart failure
correctable cardiac arrhythmia or ischaemia
acute chest infection
exacerbation of chronic chest conditions
Surgical procedures
offer replacement arthroplasty (total hip replacement or hemiarthroplasty) to patients with a displaced intracapsular hip fracture
offer total hip replacements to patients with a displaced intracapsular fracture who:
were able to walk independently out of doors with no more than the use of a stick and are
not cognitively impaired
and are medically fit for anaesthesia and the procedure
use a proven femoral stem design rather than Austin Moore or Thompson stems for arthroplasties
use cemented implants in patients undergoing surgery with arthroplasty
consider an anterolateral approach in favour of a posterior approach when inserting a hemiarthroplasty
use extramedullary implants such as a sliding hip screw in preference to an intramedullary nail in patients with trochanteric fractures above and including the lesser trochanter (AO classification types A1 and A2)
use an intramedullary nail to treat patients with a subtrochanteric fracture
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