Post-operative Management

The management of hip fracture in older adults in the postoperative setting requires a multidisciplinary approach and geriatric competencies. The main goals of the post-operative phase are early mobilisation and prevention of complications. Achieving the goal of early mobilisation requires a stable surgical repair – allowing the patient to bear weight as tolerated – effective pain control and fluid management protocols that ensure volume adequacy and avoid orthostatic hypotension. Due to age-associated decline in physiological reserve and function across multi-organ systems, hip fracture patients are at risk of multiple complications. Almost every organ is vulnerable, though cognitive dysfunction, cardiac complications and infections are the most frequent and clinically significant. A systematic approach to management, with check lists for each professional and shared protocols for the most common conditions, is an established way to improve the quality of the intervention and reduce postoperative complications. The susceptibility to complications of hip fracture elderly patients may last several days after surgical repair, thus discharge planning based on discharge needs is a crucial point in the acute management.