Patients are generally prescribed physical therapy and rehabilitation, and weight-bearing and range-of-motion activities. Interdisciplinary care programs can decrease complications and improve outcomes.[17]American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline. December 2021 [internet publication].
https://www.aaos.org/globalassets/quality-and-practice-resources/hip-fractures-in-the-elderly/hipfxcpg.pdf
This may include geriatric and orthopedic providers, alongside nursing, dietary, and rehabilitation providers such as occupational and physical therapists.[17]American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline. December 2021 [internet publication].
https://www.aaos.org/globalassets/quality-and-practice-resources/hip-fractures-in-the-elderly/hipfxcpg.pdf
Home-care may be required for household chores as well as inhouse physical therapy. There is some suggestion that extended rehabilitation may be beneficial.[129]Auais MA, Eilayyan O, Mayo NE. Extended exercise rehabilitation after hip fracture improves patients' physical function: a systematic review and meta-analysis. Phys Ther. 2012 Nov;92(11):1437-51.
http://www.ncbi.nlm.nih.gov/pubmed/22822235?tool=bestpractice.com
If an intracapsular fracture is treated with a total hip replacement, then "hip precautions" are usually warranted, which includes limiting hip flexion to a maximum of 90 degrees with no adduction in this position. This is to decrease the risk of dislocation. Patients undergoing surgery for major extremity trauma should be counseled that there may be an increased risk for surgical-site infection if they smoke or have diabetes or obesity.[57]American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. March 2022 [internet publication].
https://www.aaos.org/globalassets/quality-and-practice-resources/dod/ssitrauma/ssitraumacpg.pdf
[58]American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: appropriate use criteria. March 2022 [internet publication].
https://www.aaos.org/globalassets/quality-and-practice-resources/dod/ssitrauma/ssitraumaauc.pdf
Significant alcohol use (>14 units per week) increases the risk of infection postoperatively.[57]American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: evidence-based clinical practice guideline. March 2022 [internet publication].
https://www.aaos.org/globalassets/quality-and-practice-resources/dod/ssitrauma/ssitraumacpg.pdf
[58]American Academy of Orthopaedic Surgeons. Prevention of surgical site infections after major extremity trauma: appropriate use criteria. March 2022 [internet publication].
https://www.aaos.org/globalassets/quality-and-practice-resources/dod/ssitrauma/ssitraumaauc.pdf