References
Pre-hospital femoral neck fracture management: A review of the literature
Abstract
Introduction:
Falls are a common incident in the pre-hospital setting with a significant number resulting in fractures to the femoral neck.
There is some disagreement as to the best way to manage this injury, especially the immobilisation of the affected leg. The objective of the study was to review the literature evaluating the best practice management of patients who present with a femoral neck fracture in the Australian pre-hospital setting.
Methods:
A literature search was conducted using medical electronic databases, Medline, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from the beginning of each database until the end of September 2012.
Articles were included if they reported the pre-hospital management of a patient with a femoral neck fracture. Non-English and hospital-based articles were excluded. References from articles retrieved were reviewed.
Results:
There were 49 articles located with five articles meeting the inclusion criteria. All five articles described the evaluation of pain management techniques for patients presenting with injuries to the femoral neck. There were no studies that investigated the immobilisation of a femoral neck fracture.
Conclusions:
This study found a lack of evidence for the management of pre-hospital femoral neck fractures in Australia.
Further pre-hospital studies are required to determine the most effective pain management technique as well as the best method to immobilise a femoral neck fracture.
In the face of an ageing population Australian Beuro of Statistics (ABS),2004), the Australian healthcare industry must increasingly adapt itself to meet the health demands of the elderly. The main causes of death in the elderly are heart disease, stroke and cancer (Australian Institute of Health and Welfare, 2011), however, deaths resulting from injuries sustained in a fall are becoming more common as Australian society ages. In 2009 falls accounted for 1 370 deaths in Australia, 1 % of all deaths recorded that year.
Of those, nearly 85 % of those who died were aged 70 and over. Between 2005 and 2010, the incidence of falls increased by over 37 % (ABS, 2011). Many of those injured in a fall require transport to hospital (Gerson, 2004; Boyle et al. 2008; Flavell and Boyle, 2011) and as such it is important that any injury is properly managed in the pre-hospital setting in order to ensure a good outcome for that patient. There are a range of injuries that can be sustained in a fall. A fractured femoral neck is a common injury sustained by an elderly person in a fall (Gerson, 2004). A fractured femoral neck is a fracture between the femoral head and the trochanters (Zuckerman, 1996). This study focuses on two aspects to the management of a patient presenting with a fractured femoral neck, immobilisation and pain relief.
Subscribe to get full access to the Journal of Paramedic Practice
Thank you for visiting the Journal of Paramedic Practice and reading our archive of expert clinical content. If you would like to read more from the only journal dedicated to those working in emergency care, you can start your subscription today for just £48.
What's included
-
CPD Focus
-
Develop your career
-
Stay informed