Abstract
There is strong evidence in the medical literature that a fracture following a fall, and especially a neck of femur fracture, is one of the most serious events that can happen in an older person’s lifetime. These fractures have been associated with increased morbidity, loss of independence, a high rate of institutionalization, and mortality. Rates of mortality after a year from femoral fractures have been proven to be three to four times higher than the expected in the general population, ranging between 15% to 36%. This emphasizes the importance of developing well-organized care pathways for these patients, which combine specialized geriatric care (also known as orthogeriatric care). This narrative review will focus on the core principles of orthogeriatric care and how medical professionals, including those who are not specialized in geriatric care, can effectively use them.
A comprehensive literature search on geriatric care in patients with neck of femur and fragility fractures was undertaken across databases including PubMed, Medline, EMBASE, and the Cochrane Library, spanning the period from January 1990 to December 2022. Non-English articles, those that included data of participants younger than 60 years old or outside of Europe, and those with insufficient data or weak methodology, were excluded.
We believe the presence of a geriatrician or a medical physician with expertise in the care of olderadults is not only beneficial but should be considered the gold-standard. Importantly, orthogeriatricians play a pivotal role in the prevention of falls and fragility fractures, whilst promoting appropriate rehabilitation, reducing multidisciplinary stress through providing thorough and ongoing medical support, and reducing the chances of multiple admissions, all whilst ultimately improving outcomes for the patient and their loved ones.