Pre-hospital femoral neck fracture management: A review of the literature

Abstract

Introduction: Falls are a common incident in the pre-hospital setting with a significant number resulting in fractures to the femoral neck. There is some disagreement as to the best way to manage this injury, especially the immobilisation of the affected leg. The objective of the study was to review the literature evaluating the best practice management of patients who present with a femoral neck fracture in the Australian pre-hospital setting. Methods: A literature search was conducted using medical electronic databases, Medline, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) from the beginning of each database until the end of September 2012. Articles were included if they reported the pre-hospital management of a patient with a femoral neck fracture. Non-English and hospital-based articles were excluded. References from articles retrieved were reviewed. Results: There were 49 articles located with five articles meeting the inclusion criteria. All five articles described the evaluation of pain management techniques for patients presenting with injuries to the femoral neck. There were no studies that investigated the immobilisation of a femoral neck fracture. Conclusions: This study found a lack of evidence for the management of pre-hospital femoral neck fractures in Australia. Further pre-hospital studies are required to determine the most effective pain management technique as well as the best method to immobilise a femoral neck fracture.