ABSTRACT
In the United Kingdom, 80 000 hip and proximal femur fractures occur annually, and the incidence is due to double by 2050. The fossa is the depressed area of the acetabulum, and it contains a fat pad covered in synovial membrane. The capsule consists of two sets of fibres the circular zona orbicularis and longitudinal fibres. All patients with extracapsular fractures should undergo fixation unless they have significant symptomatic osteoarthritis, in which case consideration may be given to a calcar-replacing total hip replacement. Displaced intracapsular fractures in elderly patients require arthroplasty; undisplaced fractures may undergo fixation or replacement. External fixation is theoretically indicated in intertrochanteric fractures, with perceived benefits including potential for rapid application, minimal blood loss and ability to perform the procedure using local anaesthesia in patients with significant anaesthetic risk. The principal mechanism of injury in elderly persons is a fall from standing. Patients with displaced fractures present with groin pain, variable degrees of shortening and external rotation.
