| Abstract [eng] |
In elderly patients, the incidence of frailty fractures of the hip joint is increased by osteoporosis and a higher risk of falls. In general, hip fractures need surgical treatment, however, the right timing is crucial, since these fractures have a significant impact on patients' morbidity and mortality. This review aims to analyze the international literature and national guidelines regarding the optimal point of surgery, taking into account patients’ comorbidities as well as the infrastructure and logistics of the hospitals. Keywords were determined, and a systematic literature search was performed in medical databases. Furthermore, different national guidelines were reviewed, and their recommendations were analyzed. Most data conclude that surgery should be performed within the first 24 hours after patient's arrival. If comorbidities contradict an early operation, patients’ medical conditions should be improved within 48 hours by an interdisciplinary team of trauma surgeons, anesthetists and additional specialists. The same limit is applied if hospital infrastructure is insufficient to perform timely surgery, due to the missing specialist, the needed implant, unavailability of an intensive care bed or multiple emergency operations at the same time. In conclusion, morbidity and mortality of elderly patients with fractures of the hip joint are significantly affected by the right point of surgery. Patients should be operated on within the first 24 hours, if patient’s comorbidities and the clinic infrastructure allow it. Surgery can be postponed up to 48 hours, if needed due to comorbidities or logistics. This conclusion is limited by mostly retro perspective study design and evidence of the literature. |
