EDITORIAL 1 April - June 2025 J Gandhara Med Dent Sci How to cite this editorial Sharma A, Aging Population and the Changing Paradigm of HIP Fracture Management. J Gandhara Med Dent Sci. 2025; 12(2):1-2https://doi.org/10.37762/jgmds.12-2.698 : : Amit Sharma Cons ultant Trauma and Orthopaedics, Luton and Dunstable Hospital, Bedfordshire Hospitals NHS Trust +44 7521 712797 a mit.sharma@bedsft.nhs.uk As the global population ages, the issue of hip fractures in healthcare is becoming more significant. Once seen mainly as a concern for orthopedic surgeons, hip fractures are now recognized as a symptom of aging. The management approach has shifted to emphasize early mobilization, multidisciplinary collaboration, and comprehensive geriatric care. Traditionally, treatment focused on surgical fixatio n and postoperative rehabilitation. However, emerging evidence shows that a multidisciplinary approach improves patient outcomes. Hip fracture patients are often frail and have multiple comorbidities, necessitating medical intervention beyond orthopedic ca re. The involvement of geriatricians, especially ortho - geriatricians, is crucial for optimizing perioperative management and supporting long - term recovery. Recent studies underscore the growing burden of hip fractures worldwide. In 2019, approximately 4.1 million hip fracture cases were reported globally among individuals aged 50 and older. 1 Projections indicate that hip fractures will nearly double by 2050, primarily due to demographic shifts and an aging population. 2 This trend is particularly concerning for developing countries, where hea lthcare systems may face challenges in managing the increasing incidence of such injuries. Mortality rates associated with hip fractures remain alarmingly high. One - year all - cause mortality rates range from 14.4% in Singapore to 28.3% in the United Kingdo m. 3 These statistics highlight the critical need for timely and effective interventions to improve patient outcomes. Modern hip fracture management now relies on coordinated efforts from various healthcare professionals. Early involvement of doctors, including geriatricians and anesthetists, ensures thorough preoperative assessment. Physiotherapists and occupational therapists are vital for e nhancing outcomes in early mobilization . Pharmacists man age polypharmacy and optimize osteoporosis treatment while nursing staff provide continuous care. In Western healthcare, social services and family support are key for effective post - discharge care. Communication among all stakeholders is crucial for patie nt - centered care. Centralized hip fracture wards with standardized protocols have better outcomes than fragmented care models. 4 A key change in hip fracture management is the emphasis on early surgery, ideally within 36 hours of admission, which has been shown to decrease mortality and improve functional outcomes. Delays should be avoided, even for chronic conditions that cannot be immediately addres sed. Enhancing hydration and resuscitation before surgery improves readiness and prognosis. Additionally, early, full - weight - bearing mobilization after surgery is now encouraged to reduce complications like deep vein thrombosis and pneumonia. Tailored anesthesia approaches, particularly regional techniques like fascia iliaca blocks, are effective in reducing opioid use and lowering the risk of postoperative delirium in elderly patients. Hip fractures, often due to osteoporosis, provide a chance to start long - term treatment to prevent future fractures. Every patient with a neck o r femur fracture should be evaluated for osteoporosis and prescribed appropriate medications such as bisphosphonates. Fracture liaison services can help ensure adherence to treatm ent guidelines. Government policies and healthcare directives are vital in hip fracture management, as early surgery and multidisciplinary care can improve clinical outcomes and efficiency. Studies like the HIP ATTACK trial offer valuable insights for refi ning treatment protocols. While developed healthcare systems effectively implement these approaches, developing countries face challenges like limited resources and workforce shortages. Nevertheless, the gradual incorporation of principles such as early su rgery, dedicated orthopedic wards, and multidisciplinary teams can le ad to significant improvements. Collaboration between local and international institutions is essential for knowledge exchange and training to enhance care in these regions. Government s upport is crucial for policy changes and funding to promote early mobilization and osteoporosis management. By combining global best practices with adaptable local strategies, developing healthcare systems can significan tly improve hip fracture outcomes an d overall quality of life for aging populations. The management of hip fractures has transitioned from being mainly a surgical issue to a comprehensive, multidisciplinary challenge AGING POPULATION AND THE CHANGING PARADIGM OF HIP FRACTURE MANAGEMENT
2 J Gandhara Med Dent Sci April - June 2025 LICENSE: JGMDS publishes its articles under a Creative Commons Attribution Non-Commercial Share-Alike license ( CC-BY-NC-SA 4.0 ). COPYRIGHTS: Authors retain the rights without any restrictions to freely download, print, share and disseminate the article for any lawful purpose.It includes scholarlynetworks such as Research Gate, Google Scholar, LinkedIn, Academia.edu, Twitter, and other academic or professional networking sites. that necessitates the coordinated efforts of various healthcare professiona ls. As the global population ages, adopting and enhancing these strategies is essential to ensure that hip fracture care meets the complex needs of elderly patients. The future of hip fracture management will be defined by collaboration, innovation, and a focus on patient - centered care. REFERENCES 1. Dong Y, Zhang Y, Song K, Kang H, Ye D, Li F. What was the Epidemiology and Global Burden of Disease of Hip Fractures From 1990 to 2019? Results From and Additional Analysis of the Global Burden of Disease Study 2019. Clin Orthop Relat Res. 2023;481(6):1209 - 20. Doi: 10.1097/CORR.0000000000002465 2. Wade G. Worldwide death toll from cancer is ex pected to nearly double by 2050. New Scientist. 2024;264(3517):25. 3. Review for "Global epidemiology of hip fractures: secular trends in incidence rate, post‐fracture treatment, and all‐cause mortality". Oxford University Press (OUP); 2023. 4. Lim JW, Hut chison P, Riemen AHK, Hutchison JD. The multidisciplinary management of hip fractures in older patients: an update. Orthopaedics and Trauma. 2024;38(2):85 - 8. Aging Population and the Changing Paradigm of Hip Fracture