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Helping elderly cope with hip fractures.

"Many elderly patients who break a hip face a broad array of problems that transcend the treatment of the injury itself," points out Thomas P. Sculco, a clinical professor in the Department of Orthopaedic Surgery, Cornell University Medical College and co-director, Surgical Arthritis Service, The Hospital for Special Surgery, New York. "In many cases, an elderly person's independent existence is impacted by a fall that causes a hip fracture, an event that can forever lessen the patient's level of function."

Medical treatment for hip fractures can lead to complications in older people, depending upon their health status. Rehabilitation from hip surgery often is prolonged and discouraging to aged patients anxious to return to their own homes. Confusion and agitation can result from depression, a condition often experienced by the elderly when they have been removed from familiar surroundings and brought to a hospital environment.

"Orthopedic surgeons are playing a major role in establishing enhanced care for this special patient population," Sculco indicates. "Multidisciplinary planning has been extremely successful [for those] with other disabling conditions such as rheumatoid arthritis and is ideally suited to hip patients, too." The orthopedic specialist coordinates the efforts of the patient's physician, anesthesiologist, nurses, physical therapist, social worker, family, and friends. Together, they create a comprehensive treatment plan custom tailored to each individual.

"The team concept has led to a number of significant advances in the care of the geriatric hip patient," he reports. New fixation techniques now are being used to securely stabilize fractures, enabling individuals to get out of bed shortly after surgery. Advances in hip replacement procedures enhance mobilization. In addition, the use of regional instead of general anesthesia alleviates pain while reducing blood loss and the incidence of postoperative confusion and pulmonary problems.

Home care programs for the elderly are becoming more popular. Nursing care and physical therapy lessen the time it takes patients to recover after surgery, allowing them to return home sooner, thus alleviating the negative impact often experienced with a prolonged stay in an institutional setting.
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Publication:USA Today (Magazine)
Date:Feb 1, 1993
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