Vol. 7, Issue 3 (2021)

Purpose: Gap exists between the current guidelines for the management of fragility fractures around the hip in our country versus the best practice guidelines as defined in the British Orthopaedic Association Blue Book. We envisage to study the reasons and possible solutions to bridge them.

Methods: Longitudinal observational study with 170 patients (age>50 years) with fragility fracture of proximal femur were recruited. Patients with pathological fractures and multiple fractures were excluded. We compared our fracture management with the British Orthopaedic Association Blue book for fragility fractures. The mortality rate at one, three, and six months follow-up was also noted.

Results: 43% patients reported to the hospital within 4 hours after injury and 38.8% reported after 24 hours. 96.2% of the cases were admitted within 4 hours of presentation to casualty and 100% within 24 hours. 1 patient was operated within 48 hours of hospitalization, 23 were operated between 3-7 days and 49 after a week. 4 patients developed bed sores. No patient got an Ortogeriatrician assessment, no patient was assessed for the need for anti-resorptive therapy and no patient was offered multidisciplinary assessment to prevent future falls. Total deaths were 3, 1 and 0 at 1, 3 and 6 months of follow-up.

Conclusion: Significant gap exists in hip fracture management in our hospital compared with the best practice guidelines as mentioned in the British Orthopaedic Association blue book. Development and implementation of proven guidelines and standard protocols of care for older people with hip fractures in India will help to improve this situation.