title: Role of fracture and repair type on pain and opioid use after hip fracture in the elderly.
abstract: OBJECTIVE
  Pain after hip fracture repair is related to worse functional outcomes and higher fracture care costs than that for patients with no or less pain. However, to our knowledge, few studies have examined the roles of hip fracture type or surgical procedure as factors influencing postoperative pain or opioid analgesic requirements. Our goal was to determine whether the type of hip fracture or hip fracture repair affects postoperative pain or opioid analgesic requirements in the elderly patient.
  
  
  METHODS
  We conducted a retrospective review of 231 patients ≥65 years old admitted to a hip fracture center for surgical repair. Fracture patterns were classified into femoral neck (FN) versus intertrochanteric (IT), stable versus unstable, and type of surgical repair. Demographic and intraoperative variables, postoperative pain scores, and opioid analgesic use data were collected and analyzed according to the type of hip fracture and type of surgical repair.
  
  
  RESULTS
  There were no differences in postoperative pain when comparing FN versus IT fractures, stable versus unstable fractures, or type of surgical repair. Patients with FN fractures had higher analgesic requirements on postoperative days 1, 2, and 3. There was no difference in postoperative analgesic requirements among patients with stable versus unstable fractures or type of surgical repair. Otherwise, there were no differences in postoperative pain or opioid analgesic use based on the surgical repair or fracture type. Overall, patients with hip fracture experienced low levels of pain.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Sophia A
authors.initials: SA
authors.lastname: Strike
authors.affiliation: Department of Anesthesiology, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Frederick E
authors.initials: FE
authors.lastname: Sieber
authors.affiliation: Department of Anesthesiology, The Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Allan
authors.initials: A
authors.lastname: Gottschalk
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, MD, USA.
authors.forename: Simon C
authors.initials: SC
authors.lastname: Mears
keywords: femoral neck fracture; hip fracture; intertrochanteric fracture; pain; postoperative management