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Emergency Medicine Journal 2009;26:50-51; doi:10.1136/emj.2007.056333
© 2009 BMJ Publishing Group Ltd and the College of Emergency Medicine.

SHORT REPORTS

A retrospective chart review of elderly patients who cannot weight bear following a hip injury but whose initial x rays are normal

J E Smith1, A Jenkin2, C Hennessy2

1 Emergency Department, Derriford Hospital, Plymouth, UK
2 Faculty of Health and Social Work, University of Plymouth, Plymouth, UK

Correspondence to:
Dr J E Smith, Emergency Department, Derriford Hospital, Plymouth PL6 8DH, UK; jasonesmith{at}doctors.org.uk

ABSTRACT

Falls causing hip injury are common among older people. In elderly patients who cannot weight bear following a hip injury but have normal initial x rays, management often involves admission to the clinical decision unit for analgesia, mobilisation and physiotherapy. A proportion of these patients require further investigation due to continuing pain or inability to weight bear. There is currently no agreed pathway for these patients, who often wait days for definitive diagnosis and management. Some centres suggest investigating such patients with magnetic resonance imaging at 24 h post-admission. This study aimed to define this patient group in terms of emergency management, number undergoing further investigation and outcome. A secondary aim was to produce a management pathway for these patients.


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