Geriatric hip fracture is more than a fracture. It is actually a representation of underlying frailty of the elderly. Therefore it has a potential devastating outcomes, resulting in high mortality, substantial debility, functional loss and poor quality of life. Clearly it is not enough nor ethical to just treat a geriatric hip fracture patient by an orthopaedic surgeon with operation alone. A comprehensive geriatric assessment by a geriatrician is needed to identify background frailty and co-morbidities, to improve clinical outcomes, to formulate a long-term care plan, and to prevent repeated admissions.
The first orthogeriatric unit was established in the United Kingdon in 1953. In 2007, British Orthopae-dic Association and British Geriatric Society jointly published the famous “Blue Book”, a bible adopt-ed for hip fracture care internationally, inside which orthogeriatic model is considered as one of the six standards. Worldwide, orthogeratric co-management model is emerging as the preferred model, with the benefits of less operation delay, complications, mortality, length of stay, and higher osteopo-rosis idenfication.
United Christian Hospital has a long history in improving geriatric hip care services. Orthogeriatric collaboration was started since 1993 by our devoted geriatrician, without additional resources provided initially. Our famous weekly multidisciplinary orthogeriatic combined grand round has attracted not only local but overseas visitors. From 2015, we opened the first orthogeriatric specialty ward in Hong Kong to allow better intergration of different disciplines in provided a seamless care for our geriatric hip fracture patients. Over the years, we witnessed progressive improvement osteoporosis identification and treatment, as well as patients’ functional outcomes. Our work has been recognized internationally by being the first center obtaining Best Practise Framework recognition in the Capture-the-Fracture Programme of the International Osteoporosis Foundation since 2018.
