What are the recommended management protocols for hip fractures in older adults according to NICE guidelines?

Manage hip fractures in older adults according to NICE guidelines by ensuring timely surgical intervention, ideally on the day of or the day after admission, after correcting any correctable comorbidities such as anemia, anticoagulation, volume depletion, electrolyte imbalance, uncontrolled diabetes, heart failure, cardiac arrhythmia, or chest infection ¹.

Offer appropriate analgesia immediately upon presentation, including paracetamol every 6 hours postoperatively, with additional opioids if necessary, and consider nerve blocks to limit opioid use, administered by trained personnel ¹.

Perform surgery with the aim to allow full weight-bearing in the immediate postoperative period, with options including hemiarthroplasty or total hip replacement for displaced intracapsular fractures, considering patient suitability and preferences ¹,¹.

Use cemented implants for arthroplasty procedures, and consider a single type of cemented femoral component as standard, recording long-term outcomes for registry data ¹,¹,¹.

Implement a multidisciplinary management approach from admission, including orthogeriatric assessment, rapid optimization for surgery, early goal setting for rehabilitation, and coordinated review involving mental health, falls prevention, bone health, primary care, and social services ¹.

Offer physiotherapy assessment and mobilization on the day after surgery, with at least once daily mobilization and regular physiotherapy review ¹.

Consider early supported discharge for suitable, medically stable patients who can participate in rehabilitation and transfer short distances, with ongoing multidisciplinary involvement ¹.