Hip Fracture

A hip fracture is a fracture of the proximal femur, usually through the femoral neck or the intertrochanteric region. In an older adult, it often follows a ground-level fall rather than major trauma because osteoporosis has weakened the bone. This is a fragility fracture: the force that breaks the hip is relatively small, but the consequences can be substantial. A displaced intracapsular fracture can tear the vessels supplying the femoral head. That loss of blood flow creates a later risk of nonunion or avascular necrosis, which is one reason arthroplasty may be selected instead of internal fixation. Extracapsular fractures do not carry the same femoral-head blood-supply problem, but bleeding into the surrounding tissues can still produce clinically significant anaemia or hypovolaemia. Pain, immobility, blood loss, anaesthesia, and unfamiliar surroundings combine to make these patients vulnerable to delirium, atelectasis, pressure injury, constipation, urinary retention, venous thromboembolism (VTE), and functional decline. The fracture is therefore not simply an orthopaedic problem. The nurse is protecting perfusion, cognition, respiratory function, skin integrity, and mobility while the patient is prepared for definitive repair. Surgery is...