Despite anatomically successful fixation of distal radius and Galeazzi fractures, a subset of patients develops persistent pain and functional limitation, suggesting that factors beyond osseous alignment influence recovery. Distal radioulnar joint instability has been implicated in unfavorable outcomes, yet intraoperative assessment remains inconsistently standardized and has rarely been validated as a prognostic variable. This prospective multicenter observational cohort study included 120 consecutive patients with distal radius or Galeazzi fractures treated with plate fixation in two tertiary centers. After fracture reduction and stabilization, intraoperative distal radioulnar joint stability was systematically assessed using a previously published classification system comprising Grades I to III, with patients demonstrating no instability serving as the reference group. The primary outcome was the QuickDASH score at 12 months, while secondary outcomes included pain intensity, grip strength, radiographic distal radioulnar joint gap, and postoperative complications. Multivariable linear regression was used to evaluate the association between intraoperative instability grade and outcomes, adjusting for age, sex, fracture type, and treatment center. Increasing instability grade was independently associated with worse functional outcome, higher pain levels, reduced grip strength, and greater postoperative distal radioulnar joint widening at 12 months, with an adjusted increase of approximately 5 to 6 QuickDASH points per grade. Intraoperative distal radioulnar joint instability grading provides clinically relevant prognostic information and supports postoperative risk stratification following distal radius and Galeazzi fractures.

Introduction: Long bone fractures in children represent a substantial proportion of pediatric trauma and remain a source of therapeutic controversy due to skeletal immaturity, high remodeling potential, and growth plate considerations. Although conservative management has historically been favored, recent advances in surgical techniques and implants have led to increasing operative rates in selected fracture patterns. The relative benefits of surgical versus nonoperative treatment across different anatomical locations and age groups remain incompletely defined. Objective: To compare surgical and conservative treatment modalities for pediatric long bone fractures with respect to functional outcomes, complication rates, time to union, and need for secondary interventions, and to evaluate variations according to anatomical site, age group, and fracture characteristics. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and the International Clinical Trials Registry Platform were searched for comparative studies published within the last five years, with extension to ten years when necessary. Randomized controlled trials and comparative cohort studies evaluating operative versus nonoperative management of long bone fractures in children and adolescents were included. Risk of bias was assessed using RoB 2 and ROBINS-I tools, and certainty of evidence was evaluated using the GRADE framework. Results and Discussion: Twenty comparative studies were included, encompassing fractures of the femur, tibia, humerus, and forearm. Surgical treatment was associated with lower rates of redisplacement and earlier mobilization in selected unstable fracture patterns, particularly femoral and tibial shaft fractures in older children and adolescents. However, long-term functional outcomes were frequently comparable between operative and conservative approaches when acceptable alignment was achieved and maintained. Conservative management remained highly effective in younger children and stable fracture configurations, provided that appropriate casting technique and radiographic follow-up were ensured. Heterogeneity in study design, outcome measures, and fracture classification systems limited direct quantitative synthesis, and most available evidence derived from observational cohorts. Conclusion: Both surgical and conservative strategies can achieve satisfactory union and functional recovery in pediatric long bone fractures when appropriately selected. Treatment decisions should be individualized according to fracture stability, anatomical location, patient age, remodeling potential, and capacity for follow-up. Further high-quality randomized trials and standardized functional outcome reporting are needed to refine evidence-based treatment algorithms.

Biomechanical analysis of proximal femoral nail augmented with various screw configurations for proximal femoral fractures.

Introduction:Hand fractures of the metacarpals and phalanges account for up to 10% of all skeletal injuries and can lead to significant functional impairment if not managed appropriately. Retrograde intramedullary headless screw (IMHS) fixation is a minimally invasive technique that promises stable fixation and early mobilization, but its clinical efficacy in a prospective setting warrants evaluation.Materials and Methods:A prospective interventional study was conducted at tertiary care center from May 2023 to October 2024. Forty adult patients with simple, extra-articular metacarpal or phalanx fractures were enrolled; six were lost to follow-up, leaving 34 for analysis. Fractures were stabilized using retrograde IMHS fixation. Functional recovery was assessed at 3 weeks, 3 months, and 6 months postoperatively using the disabilities of the arm, shoulder and hand (DASH) score, hand grip strength, and total active motion (TAM) per American Society for Surgery of the Hand criteria.Results:The mean patient age was 29.29 ± 8.52 years; 82.4% were male, and 52.9% had injuries in the dominant hand. Shaft fractures predominated (83.8%). (1) DASH score improved from 47.07 ± 7.29 at 3 weeks to 27.30 ± 2.59 at 3 months and 1.32 ± 1.51 at 6 months (all P < 0.001). (2) Grip strength increased from 11.09 ± 1.75 kg at 3 weeks to 24.38 ± 3.46 kg at 3 months and 39.74 ± 4.69 kg at 6 months (all P < 0.001). (3) TAM rose from 116.18 ± 11.81° at 3 weeks to 154.71 ± 14.61° at 3 months and 268.53 ± 17.78° at 6 months (all P < 0.001).Conclusion:Retrograde IMHS fixation offers stable fracture stabilization with minimal soft-tissue disruption, enabling early mobilization and resulting in excellent functional recovery for metacarpal and phalangeal fractures.

Comparative Evaluation of Photon-Counting Detector CT and Cone-Beam CT in the Assessment of Simulated Mandibular Trauma.

Stability of Distal Ulnar Neck Fractures During Cyclic Loading Following Intramedullary Threaded Nail Fixation or Volar-Locking Plate and Screw Fixation: A Cadaveric Biomechanical Comparison.

Traumatic long bone fractures require precise reduction and stable fixation to achieve optimal outcomes during open reduction and internal fixation (ORIF). Conventional bone-holding instruments are often associated with prolonged operative time, increased blood loss, reliance on surgical assistance, and higher complication rates. This study aimed to evaluate the clinical effectiveness of a newly designed orthopedic repositioning device in reducing operative time, intraoperative blood loss, postoperative pain, and complications compared with conventional ORIF techniques. This randomized controlled clinical trial was conducted between 2023 and 2024. Adult patients aged 18-65 years with diaphyseal fractures of the femur, humerus, or tibia who underwent ORIF were enrolled. Patients were randomized into two groups: an intervention group using the novel repositioning device and a control group undergoing conventional ORIF. All surgeries were performed by a single orthopedic surgeon. The device consists of dual bone holders with a lengthening/shortening mechanism that allows controlled traction, angular correction, and plate insertion without device removal. Primary outcome measures included duration of surgery, intraoperative blood loss, postoperative pain assessed by the visual analog scale (VAS), transfusion requirement, and postoperative complications. Statistical analysis was performed using Student's t-test or Mann-Whitney U test for continuous variables and chi-square test for categorical variables, with significance set at p < 0.05. A total of 58 patients were included in the final analysis (29 per group), with a mean age of 29.9 years and a predominance of male patients (77.6%). Use of the repositioning device was associated with significantly reduced intraoperative blood loss (p < 0.05), shorter surgical duration (p < 0.05), and lower postoperative pain scores (p < 0.05) compared with the control group. The need for blood transfusion was significantly lower in the intervention group (p < 0.001). Postoperative complications occurred in 28.6% of patients in the control group but were not observed in the device group (p = 0.002). No significant difference in hospital length of stay was detected between groups (p = 0.284). Patients were followed for up to 3 months postoperatively. The novel orthopedic repositioning device improves surgical efficiency and safety in ORIF of long bone fractures by reducing operative time, blood loss, postoperative pain, and complication rates, supporting its clinical value as an effective adjunct for fracture reduction and stabilization.

BACKGROUND Intertrochanteric femoral fractures are common in older adults, and proximal femoral nail (PFN) fixation is widely preferred due to its biomechanical advantages. Lag screw cut-out, defined as the progressive migration of the lag screw through the femoral head with loss of fixation, is one of the most serious mechanical complications after PFN fixation. This complication can result in mechanical failure and require revision surgery. Therefore, this study aimed to identify independent risk factors for lag screw cut-out and evaluate lag screw stability in patients without cut-out. MATERIAL AND METHODS We retrospectively reviewed 302 patients treated with PFN between January 2023 and December 2024; 190 met the inclusion criteria. Patients were grouped by fracture stability and surgical approach. Demographic, clinical, and radiographic parameters (tip-apex distance [TAD], calcar TAD, collodiaphyseal angle, Cleveland index, lag screw advancement) were analyzed. Logistic regression identified predictors of cut-out, while sequential radiographs evaluated positional changes in non-cut-out cases. RESULTS Cut-out occurred in 30 patients (15.8%). Unstable fractures and open reduction were independent risk factors for cut-out, while age, sex, TAD, calcar TAD, Cleveland index, and collodiaphyseal angle showed no significant association. In non-cut-out cases, TAD, calcar TAD, and collodiaphyseal angle remained stable, with a mean lag screw advancement of 0.4 cm. CONCLUSIONS Unstable fractures and open surgery independently increase the risk of lag screw cut-out after PFN fixation. In contrast, non-cut-out cases showed radiographic stability, supporting the importance of accurate reduction and proper implant positioning for long-term reliability.

BackgroundThe effectiveness of surgical stabilization of rib fractures (SSRF) in patients with obesity is unknown.MethodsThe Nationwide Readmissions Database 2015-2019 was used to identify adult patients with obesity and rib fractures (RF). The outcomes of those with Obesity who underwent SSRF were compared to non-operative management (NOM) and also to non-obese participants who underwent SSRF. Patient demographics and outcomes were characterized with univariate, multivariate, and inverse-propensity score (IWPS) analyses adjusting for confounding variables and selection bias. Primary outcomes included 30-day readmission, hospital length of stay (LOS), and mortality.Results39177 patients were included Obese with NOM 86% (n = 33,516), Obese SSRF 1.8% (n = 707), and non-Obese SSRF 13% (n = 4954). While comparing between Obese NOM vs Obese with SSRF, no significant differences in all-cause 30-day-readmission rates between groups were identified through multivariate analysis (odds ratio (OR) 1.16, 95% confidence interval (CI) 0.91-1.48), or IWPS analysis (OR 0.81, CI 0.50-1.31). Patients undergoing SSRF vs NOM had increased median (IQR) LOS (12 (8-20) vs 6 (3-12) days, P < 0.001), but lower rates of in-hospital mortality (1.7% vs 6.2%, P < 0.001; OR 0.16, CI 0.09-0.28). While comparing SSRF in Obese vs non-Obese using a multivariate analysis, obesity did not confer greater odds of readmission (OR = 1.17, 95% CI 0.92-1.5) or death (OR = 0.74, 95% CI 0.4-1.35), and obesity did not contribute to a clinically significant increase in LOS (43 additional minutes, P < 0.05).DiscussionIn patients with obesity and rib fractures, SSRF is a valuable treatment option given its association with decreased rates of in-hospital mortality and comparable outcomes to their non-obese counterparts.Level of EvidenceIII.Study typetherapeutic/Care management.

The surgical stabilization of rib fractures: Secular trends in epidemiology and treatment

Simulation-based education is increasingly used in health professions training to strengthen clinical competence and self-efficacy. Paramedic students, in particular, need repeated practice opportunities to acquire essential intervention skills. Limited exposure to clinical scenarios may reduce their perceived competence and procedural success. This study aimed to evaluate the effectiveness of simulation-based training in improving paramedic students' clinical skills and to examine the impact of perceived competence and practice frequency on performance outcomes. A single-center, one-group pretest-posttest quasi-experimental design was employed with 60 students enrolled in the Paramedic Program of a public university in Türkiye. Data were collected using researcher-developed forms measuring demographics, training-related evaluations, perceived competence, and frequency of practice, with these variables assessed using Likert-type items. Eight procedural skills were assessed through structured observation based on standardized guidelines. Statistical analyses included descriptive statistics, paired samples t-tests, Wilcoxon signed-rank tests, and Spearman correlation analysis. Before training, most students had limited or no experience with core interventions, and their success rates were low. Following simulation-based education, statistically significant improvements were observed in all skills (p < 0.001), with a very large effect size for the increase in practice frequency (Cohen's d = 2.94). A 100% success rate was achieved in oxygen administration and fracture stabilization, with notable gains in advanced procedures such as intubation (90%), life support (81.7%), defibrillation (76.7%), and cardiac arrest management (75%). Perceived competence scores increased significantly (p < 0.001). A positive correlation was found between frequency of practice and perceived competence, with a correlation coefficient of Spearman's r = 0.303 (p = 0.019). Simulation-based education is effective in enhancing paramedic students' clinical performance, practice frequency, and self-perceived competence. These findings provide practical guidance for curriculum planners by supporting the structured integration of high-fidelity simulation, repeated practice opportunities, and simulation-based assessment methods into paramedic education programs. However, given the single-group pretest-posttest design, the findings should be interpreted with caution regarding causal inference. Not applicable.

The optimal cement diffusion pattern in unilateral percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) remains debated. This multicenter retrospective study investigated whether crossing the vertebral midline with bone cement is necessary under the DGOU classification. A total of 440 patients with single-level OVCFs treated by unilateral PKP (2020-2023) were categorized into OF1, OF2, or OF3 types based on the DGOU classification and further divided into crossing and non-crossing groups according to postoperative CT. Outcomes included VAS, ODI, and radiographic parameters. In OF1 fractures, no significant differences were observed between the two groups. However, for OF2 and OF3 fractures, the crossing group demonstrated significantly better ODI scores at 6 and 12 months (P < 0.001) and improved vertebral height maintenance (P < 0.001), without increasing complications. These findings suggest that achieving cross-midline cement diffusion may not be necessary for stable OF1 fractures, but it is associated with significantly better mid- to long-term functional and radiographic outcomes in unstable OF2/OF3 fracture types.

Femoral neck fractures pose significant therapeutic challenges. The femoral neck system (FNS) has emerged as a promising implant. However, deviations in the nail-shaft angle during FNS placement may compromise biomechanical stability, yet their impact remains poorly understood. We aimed to investigate the biomechanical effects of varying nail-shaft angles on stress distribution in FNS-treated femoral neck fractures (graded according to Pauwels classification) using finite element analysis, providing insights for intraoperative precision. Three-dimensional models of Pauwels type I-III fractures were reconstructed from computed tomography scans of a healthy adult femur. The FNS implants with nail-shaft angles of 120°, 125°, 130°, 135°, and 140° were virtually positioned. Axial loading (1,400N) was simulated via finite element analysis (Abaqus 2020) to evaluate the Von Mises stress distribution, peak stress magnitude, and stress transmission efficiency, and to compare mechanical failure risks across fracture types. In Pauwels type I and III fractures, a 130° nail-shaft angle minimised the peak Von Mises stress (102.7MPa and 114.7MPa, respectively), with stress concentrated near the fracture line, indicating optimal load transfer. For Pauwels type II fractures, an angle of 120° yielded the lowest peak stress (126.4MPa). Angle deviations significantly altered stress patterns: at angles ≤ 130°, type I fractures exhibited lower stress than types II/III; conversely, angles ≥ 135° reversed this trend. Angles > 130° shifted the stress concentration to the distal locking screws, thereby elevating the risk of mechanical failure. The biomechanical performance of the FNS is fracture-type-dependent, necessitating angle-specific optimisation. For Pauwels type I/III fractures, optimal nail placement at 130° enhances stress distribution, whereas type II fractures may benefit from 120° angulation. These findings underscore the criticality of intraoperative angle control in mitigating fixation failure and non-union risk. Future studies should incorporate clinical follow-ups and multi-axis loading to validate these biomechanical insights.

Distal radius fractures (DRF) are often immobilized using a conventional plaster cast although orthoses offer a time- and resource-saving alternative. This prospective randomized study compared the conservative DRF treatment using an orthosis (OPTIVOhand®) with plaster cast immobilization. Besides the maintenance of reduction result (primary endpoint), functional and subjective outcomes (secondary endpoints) were examined. 53 patients with isolated DRF were randomized to the orthosis group (OG) or the control group (CG). The follow-up examinations included radiological, clinical, and functional evaluations (ROM, grip strength, DASH score, SF-36) as well as patient satisfaction questionnaire. 41 of the 53 patients included (OG: n = 21, CG: n = 20) were followed up until the 12 months follow-up. The rate of secondary dislocations was comparable in both groups (OG: n = 3; CG: n = 2; p > 0.05). Additionally, the OG showed significantly (p < 0.05) better subjective function (DASH score) 6 weeks and 3 months after injury, and a higher quality of life (SF-36 physical component summary) at 2 and 6 week follow-up. Patient satisfaction was significantly higher in OG and mean application time was significantly shorter (OG: 02:35 min vs. CG: 07:35 min; p < 0.001). This study's functional and radiological results on conservative DRF treatment did not reveal a significant difference in maintenance of reduction result between modern orthoses and conventional plaster casts, while achieving higher patient satisfaction. Hence, orthoses offer a good alternative to plaster casts, especially for stable fracture types. German Clinical Trials Register, Identifier: DRKS00017695. Trial registration date 04.11.2019, (https://drks.de/search/en/trial/DRKS00017695).

BackgroundMost studies demonstrating efficacy of surgical stabilization of rib fractures (SSRF) are in patients with isolated severe chest wall injury. Recent evidence suggests SSRF may reduce mortality in polytrauma patients. The present study examines SSRF outcomes in severe polytrauma patients.MethodsThe 2013-2021 Trauma Quality Improvement Project database was used to identify severe polytrauma patients, defined as Injury Severity Score (ISS) ≥15 and abbreviated injury scale (AIS) ≥2 in 2 or more regions, with rib fractures. Exclusion criteria included AIS 6 in any region, death ≤72 hours, or SSRF >72 hours after admission. Outcomes of interest were in-hospital mortality, pneumonia, acute respiratory distress syndrome (ARDS), and length of mechanical ventilation. Adjustment for confounding was achieved using inverse probability of treatment weighting, Poisson regression models and quantile regression models.ResultsA total of 388091 patients met inclusion criteria, of which 1.3% (N = 5020) underwent SSRF. SSRF was associated with a 57% decreased risk of mortality (P < 0.001) and 53% lower risk of ARDS (P < 0.001). Patients who underwent SSRF also required approximately 1 day less of mechanical ventilation (P < 0.001). Patients with ISS 15-19 exhibited an association between SSRF and a 55% (P = 0.023) lower rate of pneumonia.ConclusionSSRF within 72 hours of admission in severe polytrauma patients is associated with a lower rate of mortality and acute respiratory distress syndrome, along with shorter duration of mechanical ventilation. A reduction in the rate of pneumonia was only observed among patients with ISS 15-19.

Minimally Invasive Percutanious Vertebroplasty in Management of Stable Osteoprotic Lumbar Fracture

To reduce water consumption and potential formation damage associated with conventional water-based fracturing fluids while improving the proppant-carrying and flow adaptability of CO2-based systems without relying on specialized CO2 thickeners, a CO2–water polymer hybrid fracturing fluid was developed using an AM/AA copolymer (poly(acrylamide-co-acrylic acid), P(AM-co-AA)) as the thickening agent for the aqueous phase. Systematic experimental investigations were conducted under high-temperature and high-pressure conditions. Fluid-loss tests at different CO2 volume fractions show that the CO2–water polymer hybrid fracturing fluid system achieves a favorable balance between low fluid loss and structural continuity within the range of 30–50% CO2, with the most stable fluid-loss behavior observed at 40% CO2. Based on this ratio window, static proppant-carrying experiments indicate controllable settling behavior over a temperature range of 20–80 °C, leading to the selection of 60% polymer-based aqueous phase + 40% CO2 as the optimal mixing ratio. Rheological results demonstrate pronounced shear-thinning behavior across a wide thermo-pressure range, with viscosity decreasing systematically with increasing shear rate and temperature while maintaining continuous and reproducible flow responses. Pipe-flow tests further reveal that flow resistance decreases monotonically with increasing flow velocity and temperature, indicating stable transport characteristics. Phase visualization observations show that the CO2–water polymer hybrid fracturing fluid system exhibits a uniform milky dispersed appearance under moderate temperature or elevated pressure, whereas bubble-dominated structures and spatial phase separation gradually emerge under high-temperature and relatively low-pressure static conditions, highlighting the sensitivity of phase stability to thermo-pressure conditions. True triaxial hydraulic fracturing experiments confirm that the CO2–water polymer hybrid fracturing fluid enables stable fracture initiation and sustained propagation under complex stress conditions. Overall, the results demonstrate that the AM/AA copolymer-based aqueous phase can provide effective viscosity support, proppant-carrying capacity, and flow adaptability for CO2–water polymer hybrid fracturing fluid over a wide thermo-pressure range, confirming the feasibility of this approach without the use of specialized CO2 thickeners.

Nail positioning is highly adjustable during the proximal femoral nail anti-rotation (PFNA) procedure for treating intertrochanteric fractures. Our published study demonstrates that changes in nail position can significantly affect local stress distribution, and ventral side nail insertion may increase the risk of varus deformity in the femoral head, particularly in unstable fracture types. However, adjusting the guidewire position tends to prolong operation time and increase blood loss. The necessity of this adjustment in stable fracture cases remains to be clarified. This retrospective study reviewed the clinical data of patients with stable intertrochanteric fractures (AO 31-A1 and A2.1) who were treated with PFNA operation and had a minimum follow-up of 6months. Nail position was assessed using immediate postoperative lateral radiographs. A correlation between nail positioning and femoral head varus has been established. Furthermore, to corroborate the clinical findings, the biomechanical effects of nail position variation were evaluated using a stable fracture model. Specifically, femoral head displacement, as well as stress values within the femoral head and at the bone-screw interfaces, were analyzed. This study integrated retrospective clinical data analysis with computational mechanical simulations, which yielded a similar trend. The clinical review included a total of 53 patients, comprising 27 with ventral and 26 with dorsal nail positions. No statistically significant difference was observed in the femoral head varus angle between the ventral and dorsal placement groups (t = -0.683, p = 0.497). Furthermore, computational simulations indicated that variations in nail position did not significantly alter the stress distribution or displacement of either the femoral head or the anti-rotation blade under compressive or physiological loading conditions. The position of the PFNA nail has only a minimal impact on fixation stability and stress distribution around the femoral head in stable intertrochanteric fractures. Therefore, intraoperative guidewire adjustments are unnecessary when treating such stable fractures with PFNA.

The SpineJack system is a minimally invasive device designed to restore vertebral height and stability in vertebral compression fractures (VCFs). This systematic review and meta-analysis evaluates its clinical efficacy, safety, and potential advantages over conventional treatments. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed, Embase, and Scopus were searched on July 20, 2024, for original clinical studies involving adult patients with VCFs treated using the SpineJack system. Studies reporting quantitative outcomes such as pain (Visual Analog Scale, VAS), disability (Oswestry Disability Index, ODI), and vertebral body height (VBH) restoration were included. Data were pooled using random-effects models, and publication bias was assessed through funnel plots and regression analysis. 18 studies comprising 1482 patients (930 treated with SpineJack) met the inclusion criteria. Fracture etiologies included osteoporotic, traumatic, and pathologic. Meta-analysis demonstrated significant reductions in pain (VAS standardized mean difference (SMD) 2.26, 95% CI 1.68 to 2.84, P<0.001) and disability (ODI SMD 3.64, 95% CI 2.91 to 4.38, P<0.001). Restoration of anterior VBH (SMD 1.45, 95% CI 1.12 to 1.78, P<0.001, I²=0%), and middle VBH (SMD 3.93, 95% CI 1.51 to 6.34, P=0.001) were both significant. Reported complications were infrequent and primarily minor. The SpineJack system provides a safe and effective minimally invasive option for VCF management, yielding considerable improvements in pain relief, functional recovery, and vertebral height restoration. Additional high-quality studies are warranted to further define its comparative advantages and long-term outcomes.

Purpose:Despite an increase in hip fractures in Latin America, few studies have assessed management of these injuries in this region, impeding efforts to understand current treatment patterns, highlight knowledge deficits, or develop best practice guidelines. This study sought to determine current practices in hip fracture management reported by surgeon-experts in Latin America.Methods:Based on input from a panel of Latin American orthopaedic traumatologists, a case-based survey evaluating hip fracture management preferences was developed and distributed using a snowball sampling method. One surgeon-leader per Spanish- and Portuguese-speaking Latin American country identified ≤10 surgeons experienced in treating hip fractures.Results:A total of 124 respondents from 16 countries completed the survey. For femoral neck fractures, internal fixation of any kind was the most reported method for nondisplaced fractures, except for patients >80 years old and unhealthy. Multiple screws were the most commonly reported internal fixation device for nondisplaced fractures across all age groups. For displaced femoral neck fractures, arthroplasty was the most reported treatment in all scenarios, except for patients <65 years old and healthy, in which internal fixation predominated. For intertrochanteric fractures, a short cephalomedullary nail was the most reported fixation method in all scenarios, particularly for patients <65 years old with unstable fractures who were healthy and community ambulators. For stable intertrochanteric fractures, a sliding hip screw was the second most reported fixation method. In unstable fracture patterns, a long cephalomedullary nail was the second most commonly reported fixation method. The use of arthroplasty for intertrochanteric fractures generally increased with patient age and was most commonly used in patients >80 years old with an unstable fracture who were unhealthy and minimal/nonambulators. Postoperatively, non–weight bearing was most often preferred for unstable fractures treated with internal fixation, and full weight bearing was commonly recommended for stable fractures treated with arthroplasty. Most respondents considered fracture pattern, patient age, preoperative function and quality of life, and quality of reduction as the most important factors when choosing between fixation and arthroplasty.Conclusion:The findings from this study established foundational knowledge on hip fracture management and will be used to ultimately develop recommendations and targeted interventions in hip fracture care in Latin America.Level of Evidence:N/A.