Advising Frail Patients on Managing Proximal Femoral Fractures

Managing proximal femoral fractures (i.e., trochanteric or femoral neck fractures) in frail older patients often defaults to surgical fixation because data on outcomes of nonoperative management are lacking. In this observational study from the Netherlands, researchers assessed a cohort of 172 frail older nursing home residents (median age, 86) with proximal femoral fractures, of whom half underwent operative management following structured shared decision making that involved patients and their surrogates. Frailty was defined as having severe malnutrition (body-mass index, <18.5 kg/m²), cachexia, severe comorbidities, or severe impairment of mobility.

The two groups were similar in baseline characteristics; nearly all patients had dementia.…