Periprosthetic hip fracture

Clinical presentation

Periprosthetic hip fractures in elderly patients often occur result from low energy mechanisms.

Clinical assessment

Important history include

• mechanism of injury (look for associated injuries e.g. head injury, other fractures, rhabdomyolysis following long lie)

• joint replacement details (when, where, surgeon, revision history?)

• significant past medical history (fitness for surgery, other joint )

• drug history (particularly anticoagulation, steroids)

• functional history (e.g. walking aids, exercise tolerance, ADLs)

Imaging

Pelvis and full femur x ray - This helps to determine site and configuration of fracture

A&E management

• look for medical causes for fall

• take bloods (FBC, U&Es, coag screen, G&S x2)

• provide analgesia

• refer to ortho oncall team.