Anaesthesia for fractured neck of femur

Abstract

Femoral neck fractures are painful, debilitating and associated with significant morbidity and mortality. Early surgery is important to facilitate recovery and restoration of mobility. A multidisciplinary team of anaesthetists, orthopaedic surgeons, orthogeriatricians, nurses and allied health staff can provide comprehensive assessment and care for these high-risk patients. Preoperative evaluation emphasizes risk stratification and medical optimization. Multimodal analgesia, including systemic analgesics and peripheral nerve blocks, plays an integral part. Other specific issues include cardiac complications, venous thromboembolism, bone cement implantation syndrome and postoperative cognitive dysfunction. Postoperative rehabilitation should start as early as possible and structured clinical care pathways can be implemented to facilitate integrated management and smooth recovery for these patients.