Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients

In the United States, more than 300,000 hip fractures occur annually in the elderly population with associated significant morbidity and mortality. Both intracapsular and extracapsular hip fractures have inherent treatment challenges and therefore are at risk of nonunion complications. A systematic...

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Main Authors: Sharon Babcock, James F. Kellam
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Advances in Orthopedics
Online Access:http://dx.doi.org/10.1155/2018/1912762
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author Sharon Babcock
James F. Kellam
author_facet Sharon Babcock
James F. Kellam
author_sort Sharon Babcock
collection DOAJ
description In the United States, more than 300,000 hip fractures occur annually in the elderly population with associated significant morbidity and mortality. Both intracapsular and extracapsular hip fractures have inherent treatment challenges and therefore are at risk of nonunion complications. A systematic assessment including radiographic, metabolic, and infectious evaluations should be completed for all patients suspected of nonunion. Failed internal fixation of intracapsular hip fractures is typically treated with arthroplasty, while extracapsular proximal femur nonunions may be amenable to revision internal fixation or arthroplasty. While not a classic hip fracture, bisphosphate associated subtrochanteric femur fractures affect a similar patient population and are historically difficult to treat. Atypical subtrochanteric femur fractures are at increased risk of nonunion given the altered biologic environment secondary to bisphosphonate use; therefore adjuvant therapies may be beneficial in setting of revision fixation. Having a thorough understanding of nonunion risks, recognition, evaluation, and treatment is necessary for appropriate patient care.
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spelling doaj-art-2e7e11b91ea8423db0628472fa0b3a0f2025-08-20T03:55:07ZengWileyAdvances in Orthopedics2090-34642090-34722018-01-01201810.1155/2018/19127621912762Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly PatientsSharon Babcock0James F. Kellam1Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston Salem, NC, USADepartment of Orthopaedic Surgery, UT Health Science Center at Houston, Houston, TX, USAIn the United States, more than 300,000 hip fractures occur annually in the elderly population with associated significant morbidity and mortality. Both intracapsular and extracapsular hip fractures have inherent treatment challenges and therefore are at risk of nonunion complications. A systematic assessment including radiographic, metabolic, and infectious evaluations should be completed for all patients suspected of nonunion. Failed internal fixation of intracapsular hip fractures is typically treated with arthroplasty, while extracapsular proximal femur nonunions may be amenable to revision internal fixation or arthroplasty. While not a classic hip fracture, bisphosphate associated subtrochanteric femur fractures affect a similar patient population and are historically difficult to treat. Atypical subtrochanteric femur fractures are at increased risk of nonunion given the altered biologic environment secondary to bisphosphonate use; therefore adjuvant therapies may be beneficial in setting of revision fixation. Having a thorough understanding of nonunion risks, recognition, evaluation, and treatment is necessary for appropriate patient care.http://dx.doi.org/10.1155/2018/1912762
spellingShingle Sharon Babcock
James F. Kellam
Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients
Advances in Orthopedics
title Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients
title_full Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients
title_fullStr Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients
title_full_unstemmed Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients
title_short Hip Fracture Nonunions: Diagnosis, Treatment, and Special Considerations in Elderly Patients
title_sort hip fracture nonunions diagnosis treatment and special considerations in elderly patients
url http://dx.doi.org/10.1155/2018/1912762
work_keys_str_mv AT sharonbabcock hipfracturenonunionsdiagnosistreatmentandspecialconsiderationsinelderlypatients
AT jamesfkellam hipfracturenonunionsdiagnosistreatmentandspecialconsiderationsinelderlypatients