title: Occurrence, management and outcomes of hip fractures in patients with Parkinson's disease.
abstract: BACKGROUND
  Hip fractures can be debilitating, especially in patients with pre-existing Parkinson's disease; they have reportedly worse outcomes than non-Parkinson's disease patients.
  
  
  METHODS
  A computerized literature search on PubMed, Medline, Embase, and CINAHL, supplemented by a manual search of related publications.
  
  
  RESULTS
  Parkinson's disease patients were found to have significantly lower bone mineral density; higher incidence of falls and hip fractures; delays to receiving their Parkinson's disease medication and surgery; higher risk of pneumonia, urinary infection, pressure sores, post-operative mortality; surgical complications and sequelae, including failed fixation, dislocation, longer hospital stay, re-operation; and increased risk of contralateral hip fracture.
  
  
  RESULTS
  Regain of mobility and return to previous residential status have been variably reported.
  
  
  CONCLUSIONS
  All Parkinson's disease patients should be screened and considered for primary prevention treatment. On admission with hip fractures, attention should be paid to avoid delays to medication, ensuring safe anaesthetic and timely surgery, and post-operative chest physiotherapy and mobilization.
  
  
  METHODS
  Research is needed in minimizing the bone-resorptive effects of anti-Parkinson's disease medication.
authors.affiliation: Department of Trauma and Orthopaedics, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, Tyne and Wear NE7 7DN, UK.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Critchley
authors.affiliation: Department of Trauma and Orthopaedics, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, Tyne and Wear NE7 7DN, UK sameer.khan@doctors.net.uk.
authors.forename: Sameer K
authors.initials: SK
authors.lastname: Khan
authors.affiliation: Institute of Neuroscience, Clinical Ageing Research Unit, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, Tyne and Wear NE4 5PL, UK.
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Yarnall
authors.affiliation: Department of Trauma and Orthopaedics, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, Cambridgeshire PE3 9GZ, UK.
authors.forename: Martyn J
authors.initials: MJ
authors.lastname: Parker
authors.affiliation: Department of Trauma and Orthopaedics, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, Tyne and Wear NE7 7DN, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Deehan
mesh_terms: D000058:Accidental Falls; D000758:Anesthesia / Q000379:methods; D005592:Fracture Fixation / Q000009:adverse effects / Q000379:methods*; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D058866:Osteoporotic Fractures / Q000453:epidemiology / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology; D011183:Postoperative Complications; D018570:Risk Assessment / Q000379:methods
keywords: Parkinson's disease; bone mineral density; falls; hip fractures