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January 9, 1978

Hip Fractures in Elderly Patients

Author Affiliations

Kingsbrook Jewish Medical Center Brooklyn, NY

JAMA. 1978;239(2):106-107. doi:10.1001/jama.1978.03280290026005

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To the Editor.—  In their article "Non-treatment of Hip Fractures in Senile Patients" (238:1175-1176, 1977), Lyon and Nevins have demonstrated in a series of five cases that senile patients can avoid such common complications of hip fractures as decubitus ulcer and pneumonia without undergoing surgery provided they receive diligent, intensive nursing care. In publishing these cases, the authors have properly drawn attention to the critical importance of diligent nursing care in the treatment of the elderly patient with a hip fracture.However, a series of five patients hardly justifies their conclusion that nonoperative management is a "reasonable alternative" to surgery. To confirm this viewpoint would require a comparative study of two substantially larger groups of patients, one surgical and one nonsurgical, who receive equally comprehensive nursing care. Until such a study is made, many of us will continue to operate on ambulatory as well as nonambulatory senile patients with hip