Fractured Neck of Femur

Pathway

Mr Naveed Shaikh

Consultant Trauma & Orthopaedic Surgeon

23/11/2015

Fracture of the hip

Average age 85 (fragility

fracture)

70000/year

Operation depends on

type of fracture

DHS

The Problem:

Patients have other

comorbities.

Extended bed days and

social care

Incidence increasing

• Prevention

- Falls clinics (community based)

- Treatment of osteoporosis

• Optimal management

- Follow NICE guidelines

- BPT compliance

- Audit (national hip fracture database)

Management overview

• Hip fracture

• Assess patient

• Analgesia

• Information and support

• Surgery

• MDT rehabilitation

• Assess future fracture risk

NICE

• MRI for occult hip fracture

• Perform surgery same or following day

• Analgesia

• Anaesthesia

• Planned trauma list with appropriate operation

• Post-op mobilisation day after surgery

• Orthogeriatric input

• Integrated care pathway

• Early supported discharge

Best practice tarrif

Audit results

Summary

• Incidence of fractured neck of femurs increasing

• Require a MDT approach

• Follow the NICE guidance

• Adhere to BPT criteria

• Audit

Thankyou

Mr Naveed Shaikh

Consultant trauma and orthopaedic surgeon