Cleveland Clinic journal of medicine
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Morbidity and mortality rates associated with acute hip fracture remain high. Over the past decade, the management of hip fracture has shifted to emphasize prompt surgical treatment, multimodal analgesia to reduce opioid use, and incorporation of enhanced recovery pathways. ⋯ Prophylaxis of venous thromboembolism, treatment of preoperative anemia and acute kidney injury, and cardiac stabilization are important measures to reduce morbidity. Multimodal analgesia incorporating regional anesthesia techniques may help prevent delirium and facilitate early participation in physical therapy to reduce complications.
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Several studies published in the last year have shed light on the preoperative assessment of perioperative cardiovascular risk and on the need for anticoagulation in patients with postoperative atrial fibrillation, which are reviewed here.
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Editorial Comment
Calcium pyrophosphate deposition and crowned dens syndrome.