Interdisciplinary consensus on the care of elderly patients with hip fractures based on an orthogeriatric approach

This consensus was prepared by a group of experts from various specialties in the interests of improving the quality of specialized medical care for elderly and senile patients with hip fractures, which are almost always the result of osteoporosis and an increased risk of falls. Difficulties in the treatment of this category of patients are due to both the severity of the injury itself and comorbidity, which is accompanied by high mortality and extremely low quality of life for survivors. Effective management of such patients is possible only with the joint involvement of doctors and nurses of surgical and internal medicine and geriatric profiles within the framework of the so-called orthogeriatric approach. Experts in the field of traumatology and orthopedics, anesthesiology and intensive care, geriatrics, rehabilitation, clinical pharmacology, therapy, rheumatology and endocrinology based on the available clinical recommendations and orders of the Ministry of Health Care of the Russian Federation, literature data and general discussion formulated the basic principles of interdisciplinary management of elderly and senile people with hip fracture. The aim of the consensus is to help establishing effective interaction between professionals of different specialties based on their better mutual understanding, which will contribute to improving specialized medical care, saving lives and reducing disability of elderly patients with hip fracture.

1. A set of measures aimed at preventing falls and fractures in elderly and senile people / O.N. Tkacheva, Yu.V. Kotovskaya, A.V. Rozanov [and etc]. — Электрон. дан. — M., 2021. 48 p. (In Russ.). Режим доступа: https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/061/360/original/KoMnneKCмер_падения_2021.pdf, свободный.

2. Lesnyak O, Ershova O, Belova K, Gladkova E, Sinitsina O, et al. Epidemiology of fracture in the Russian Federation and the development of a FRAX model. Arch Osteoporos. 2012;7(1-2):67-73. doi: https://doi.org/10.1007/s11657-012-0082-3

3. Raskina T.A., Averkieva Y. V. Sociomedical sequels and quality of life in patients of old age group with proximal femoral fractures. Sovremennaya Revmatologiya = Modern Rheumatology Journal. 2014 ; 8(3) : 51-55. (In Russ.). doi: https://doi.org/10.14412/1996-7012-2014-3-51-55

4. Raskina T. A., Averkieva Y. V. Outcomes of hip fractures in olderindividuals in Kemerovo depending on patient management tactics // Siberian Medical Journal (Irkutsk). 2011 ; 100(1) : 151-154. (In Russ.).

5. Shubnyakov I. I., Vorontsova T. N., Bogopolskaya A. S., et al. Mortality in patients with proximal femur fractures undergoing conservative and surgical treatment. Pirogov Russian Journal of Surgery. 2022 ; (4) : 60-68. (In Russ.). doi: https://doi.org/10.17116/hirurgia202204160

6. Ershova O.B., Belova K.Yu., Degtyarev A. A.,et al. Analysis of mortality in patients with a fracture of the proximal femur. Osteoporosis and Bone Diseases. 2015; 18(3) : 3-8. (In Russ.). doi: 10.14341/osteo201533-8

7. Gladkova E.N., Khodyrev V.N., Lesnyak O.M. Analysis of the state of medical care and outcomes in patients with proximal femur fracture (data from a population-based study). Osteoporosis and Bone Diseases. 2011 ; 14(3) : 7-10. (In Russ.). doi: 10.14341/osteo201137-10.

8. Bashkova I.B., Bezlyudnaya N.V., Shutova I.I., Kindyakova N.V., Tarasov A.N. Surgical activity for proximal femur fracture in men. Osteoporosis and osteopathy. 2022 ; 25(3) : 16-17. (In Russ.). doi: https://doi.org/10.14341/osteo12980.

9. Vorontsova T.N., Bogopol'skaya A. S., Cherny A.Zh., Shevchenko S.B. The structure of the contingent of patients with fractures of the proximal femur and the calculation of the average annual need for emergency surgical treatment. Traumatology and Orthopedics of Russia. 2016 ; 1(79) : 7-20. (In Russ.). doi: https://doi.org/10.21823/2311-2905-2016-0-1.

10. Tebenko E.A., Dmitrachenko M.N., Kostiv E.P. Features of providing assistance to elderly and senile patients with proximal femur fractures // Current issues of modern medicine: materials of the VII Far Eastern Medical Youth Forum (Far Eastern State Medical University, Khabarovsk, October 2-14, 2023) / Responsible. Editor I.V. Tolstyonok. Khabarovsk : Publishing house of FESU. 2023 ; P. 89-90. (In Russ.). ISBN 978-5-85797-410-0.

11. Kanis JA, Johansson H, Harvey NC, Gudnason V, Sigurdsson G, et al. Adjusting conventional FRAX estimates of fracture probability according to the recency of sentinel fractures. Osteoporos Int. 2020;31(10):1817-1828. doi: https://doi.org/10.1007/s00198-020-05517-7

12. Lott A, Pflug EM, Parola R, Egol KA, Konda SR. Predicting the Subsequent Contralateral Hip Fracture: Is FRAX the Answer? J Orthop Trauma. 2022;36(12):599-603. doi: https://doi.org/10.1097/BOT.0000000000002441

13. Kay RS, Ho L, Clement ND, Duckworth AD, Hall AJ. The incidence of subsequent contralateral hip fracture and factors associated with increased risk: the IMPACT Contralateral Fracture Study. Osteoporos Int. 2024;35(5):903-909. doi: https://doi.org/10.1007/s00198-024-07039-y

14. Belova K. Yu. Organization of medical care for patients with severe osteoporosis: Monograph / Belova K.Yu., Ershova O.B. — Krasnoyarsk: Scientific Innovation Center, 2016. — 162 p. (In Russ.). ISBN 978-5-906314-47-5.

15. Chernysheva I.S., Molova E.A. Management of osteoporotic fractures in real clinical practice // Endocrinology: news, opinions, training. 2023 ; 12(2) : 128-130. (In Russ.). doi: https://doi.org/10.33029/2304-9529-2023-12-2-128-130.

16. Seryapina Yu.V., Fedyaev D.V., Musina N.Z. Analysis of demographic, social and economic effects in the implementation of surgical treatment of proximal femur fractures in geriatric patients in the Russian Federation. Russian Journal of Geriatric Medicine. 2021 ; 2(6) : 191-200. (In Russ.). doi: https://doi.org/10.37586/2686-8636-2-2021-191-200.

17. Van Heghe A, Mordant G, Dupont J, Dejaeger M, Laurent MR, Gielen E. Effects of Orthogeriatric Care Models on Outcomes of Hip Fracture Patients: A Systematic Review and Meta-Analysis. Calcif Tissue Int. 2022;110(2):162-184. doi: https://doi.org/10.1007/s00223-021-00913-5

18. Hawley S, Javaid MK, Prieto-Alhambra D, Lippett J, Sheard S, et al. REFReSH study group. Clinical effectiveness of orthogeriatric and fracture liaison service models of care for hip fracture patients: population-based longitudinal study. Age Ageing. 2016;45(2):236-42. doi: https://doi.org/10.1093/ageing/afv204

19. Mukherjee K, Brooks SE, Barraco RD, Como JJ, Hwang F, et al. Elderly adults with isolated hip fractures-orthogeriatric care versus standard care: A practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(2):266-278. doi: https://doi.org/10.1097/TA.0000000000002482

20. Danazumi MS, Lightbody N, Dermody G. Effectiveness of fracture liaison service in reducing the risk of secondary fragility fractures in adults aged 50 and older: a systematic review and meta-analysis. Osteoporos Int. 2024;35(7):1133-1151. doi: https://doi.org/10.1007/s00198-024-07052-1

21. European Physical and Rehabilitation Medicine Bodies Alliance. White Book on Physical and Rehabilitation Medicine in Europe. Introductions, Executive Summary, and Methodology. Eur J Phys Rehabil Med. 2018;54(2):125-155. doi: https://doi.org/10.23736/S1973-9087.18.05143-2

22. Handbook of hip surgery Volume 2 / edited by R.M. Tikhilov, I.I. Shubnyakov. — St. Petersburg: Russian Order of the Red Banner of Labor Research Institute of Traumatology and Orthopedics named after R. R. Vreden, 2015. 355 p. (In Russ.). ISBN 978-5-9904897-2-1.

23. Bettelli G. Anaesthesia for the elderly outpatient: preoperative assessment and evaluation, anaesthetic technique and postoperative pain management. Curr Opin Anaesthesiol. 2010;23(6):726-31. doi: https://doi.org/10.1097/ACO.0b013e3283400b6c

24. Order of the Ministry of Health of the Russian Federation dated July 31, 2020 No. 788n «On approval of the Procedure for organizing medical rehabilitation of adults» (Registered on September 25, 2020 No. 60039). (In Russ.). Режим доступа: http://publication.pravo.gov.ru/Document/View/0001202009250036, свободный. (Посл. Посещение 02.01.2025.)

25. Orthogeriatrics. Management of elderly patients with low-energy fractures: a guide / edited by P. Falaschi, D. Marsh; translated from English by O.M. Lesnyak. — Moscow: GEOTAR-Media, 2022. — 464 p.: ill. (In Russ.). ISBN: 978-5-9704-6489-2.

26. Caring for a patient with a low-energy fracture. A holistic approach to managing orthogeriatric patients: a guide / edited by K. Hertz, J. Santi-Tomlinson; trans. from English by A.A. Popov [et al.]; ed. trans. by O.M. Lesnyak. Moscow : GEOTAR-Media, 2021. 56 p.: ill. (In Russ.) doi: https://doi.org/10.33029/9704-6116-7-HOL-2021-1-256.

27. Proximal femur fractures. Clinical guidelines, 2021. Ministry of Healthcare of the Russian Federation. — 2021 (In Russ.). Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/729_1, свободный.

28. Pathological fractures complicating osteoporosis. Clinical guidelines., 2022. Ministry of Healthcare of the Russian Federation. — 2022 (In Russ.) Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/614_2, свободный.

29. Chronic pain syndrome (CPS) in adult patients requiring palliative care. Clinical guidelines, 2023. Ministry of Healthcare of the Russian Federation. — 2023 (In Russ.). Режим доступа: https://cr.minzdrav.gov.ru/previewcr/400_2, свободный.

30. Frailty. Clinical guidelines, 2024. Ministry of Healthcare of the Russian Federation. — 2024 (In Russ.). Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/613_2, свободный.

31. Dubrov V.E., Shelupaev A.A., Arutyunov G.V., et al. Fractures of the proximal femur. Clinic, diagnostics and treatment (Clinical guidelines, abridged). Bulletin of Traumatology and Orthopedics named after N. N. Priorov. 2021 ; 28(4) : 49-89. (In Russ.). doi: 10.17816/vto100763.

32. Perioperative management of elderly and senile patients. Guidelines, 2021. Ministry of Healthcare of the Russian Federation. — 2021 (In Russ.). Режим доступа: https://apicr.minzdrav.gov.ru/Files/recomend/MP104.PDF, свободный.

33. Uysal Aİ, Altıparmak B, Yaşar E, Turan M, Canbek U, et al. The effects of early femoral nerve block intervention on preoperative pain management and incidence of postoperative delirium geriatric patients undergoing trochanteric femur fracture surgery: A randomized controlled trial. Ulus Travma Acil Cerrahi Derg. 2020;26(1):109-114. doi: https://doi.org/10.14744/tjtes.2019.78002

34. Morrison C, Brown B, Lin DY, Jaarsma R, Kroon H. Analgesia and anesthesia using the pericapsular nerve group block in hip surgery and hip fracture: a scoping review. Reg Anesth Pain Med. 2021;46(2):169-175. doi: https://doi.org/10.1136/rapm-2020-101826

35. Ramlogan R, Uppal V. Hip fracture analgesia: how far ahead are we? Can J Anaesth. 2024;71(6):692-697. doi: https://doi.org/10.1007/s12630-023-02664-3

36. Melkonyan G.G., Protsenko D.N., Runikhina N.K., et al. A Consensus on Current Issues of Multidisciplinary Care for Geriatric Patients with Frailty Undergoing Routine Surgical Procedures. Russian Journal of Geriatric Medicine. 2024 ; (3) : 162-173. (In Russ.). doi: https://doi.org/10.37586/2686-8636-3-2024-162-173.

37. Leiderman I.N., Gritsan A.I., Zabolotskikh I.B., et al. Perioperative nutritional support. Russian Federation of anesthesiologists and reanimatologists guidelines. Alexander Saltanov Intensive Care Herald. 2018 ; (3) : 5-21. (In Russ.). doi: https://doi.org/10.21320/1818-474X-2018-3-5-21.

38. Delirium not caused by alcohol and other psychoactive substances in elderly and senile people. Clinical guidelines, 2022. Ministry of Healthcare of the Russian Federation. — 2022 (In Russ.). Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/742_1, свободный.

39. Yu SJ, Yang Y, Zang JC, Li C, Wang YM, Wang JB. Evaluation of Serum 25-Hydroxyvitamin D3 and Bone Mineral Density in 268 Patients with Hip Fractures. Orthop Surg. 2021;13(3):892-899. doi: https://doi.org/10.1111/os.12920

40. Ingstad F, Solberg LB, Nordsletten L, Thorsby PM, Hestnes I, Frihagen F. Vitamin D status and complications, readmissions, and mortality after hip fracture. Osteoporos Int. 2021;32(5):873-881. doi: https://doi.org/10.1007/s00198-020-05739-9

41. Di Monaco M, Castiglioni C, Di Carlo S, La Marmora E, Filipovic I, et al. Classes of vitamin D status and functional outcome after hip fracture: a prospective, short-term study of 1350 inpatients. Eur J Phys Rehabil Med. 2019;55(1):56-62. doi: https://doi.org/10.23736/S1973-9087.18.05191-2

42. Osteoporosis. Clinical guidelines, 2021. Ministry of Healthcare of the Russian Federation. — 2021 (In Russ.) Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/87_4, свободный.

43. Bozhkova S.A., Tikhilov R.M., Andriyashkin V.V., et al. Prevention, Diagnosis and Treatment of Thromboembolic Complications in Traumatology and Orthopedics: Methodological Guidelines // Traumatology and Orthopedics of Russia. 2022 ; 28(3) : 136-166. (In Russ.). doi: https://doi.org/10.17816/2311-2905-1993.

44. Perioperative management of patients eceiving long-term antithrombotic therapy. Clinical practice recommendations of the national «Federation of Anesthesiologists and Reanimatologists». Annals of Critical Care. 2021 ; (3) : 7-26. (In Russ.). doi: 10.21320/1818-474X-2021-3-7-26.

45. Revishvili A.Sh., Shlyakhto E.V., Zamyatin M.N., et al. Peculiar features of urgent and emergency medical care of patients taking direct oral anticoagulants: Consensus statement of multidisciplinary expert group. Journal of Arrhythmology. 2018 ; (92) : 59-72 (In Russ.). doi: https://doi.org/10.25760/VA-2018-92-59-72.

46. Llau J V., Kamphuisen P, Albaladejo P. European guidelines on perioperative venous thromboembolism prophylaxis. Eur J Anaesthesiol. 2018;35(2):139-141. doi: https://doi.org/10.1097/EJA.0000000000000716

47. Prevention of surgical site infections: Clinical guidelines / N.I. Briko, S.A. Bozhkova, E.B. Brusina, [et al.]; Ministry of Health of the Russian Federation; National Association of Healthcare Associated Infection Control Specialists. — Nizhny Novgorod: Remedium Privolzhye, 2018. — 72 p. (In Russ.) ISBN 978-5-906125-53-8

48. Gillespie WJ, Walenkamp GH. Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures. Cochrane Database Syst Rev. 2010(3):CD000244. doi: https://doi.org/10.1002/14651858.CD000244.pub2

49. Sharipova V.Kh., Bokiev K.Sh., Berdiev N.F., Mikhliev A.N. ERAS protocol — time to reconsider views! Bulletin of emergency medicine. 2021 ; 14(6) : 93-99. (In Russ.). doi: 10.54185/TBEM/vol14_iss6/a17.

50. Hirsch KR, Wolfe RR, Ferrando AA. Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery. Nutrients. 2021;13(5):1675. doi: https://doi.org/10.3390/nu13051675

51. Griffiths R, Babu S, Dixon P, Freeman N, Hurford D, Kelleher E, et al. Guideline for the management of hip fractures 2020: Guideline by the Association of Anaesthetists. Anaesthesia. 2021;76(2):225-237. doi: https://doi.org/10.1111/anae.15291

52. Iron deficiency anemia. Clinical guidelines, 2024. Ministry of Healthcare of the Russian Federation. — 2024 (In Russ.). Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/669_2, свободный.

53. Practical Traumatology: A Guide for Physicians / edited by V.V. Klyuchevsky, I.I. Litvinov. Moscow: Limited Liability Company «Practical Medicine», 2020. 400 p. (In Russ.). — ISBN 978-5-98811-610-3.

54. Vail EA, Feng R, Sieber F, et al. Long-term Outcomes with Spinal versus General Anesthesia for Hip Fracture Surgery: A Randomized Trial. Anesthesiology. 2024;140(3):375-386. doi: https://doi.org/10.1097/ALN.0000000000004807

55. Li T, Li J, Yuan L, et al. Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial [published correction appears in JAMA. 2022 Mar 22;327(12):1188. doi: 10.1001/jama.2022.3565]. JAMA. 2022;327(1):50-58. doi: https://doi.org/10.1001/jama.2021.22647

56. Neuman MD, Feng R, Ellenberg SS, et al. Pain, Analgesic Use, and Patient Satisfaction With Spinal Versus General Anesthesia for Hip Fracture Surgery : A Randomized Clinical Trial. Ann Intern Med. 2022;175(7):952-960. doi: https://doi.org/10.7326/M22-0320

57. Love AL, Cornwell PL, Whitehouse SL. Oropharyngeal dysphagia in an elderly post-operative hip fracture population: a prospective cohort study. Age Ageing. 2013;42(6):782-5. doi: https://doi.org/10.1093/ageing/aft037

58. Турушева А.В., Моисеева И.Е. Недостаточность питания в пожилом и старческом возрасте // Российский семейный врач. — 2019. — Т. 23. — № 1. — С. 5-15. [Turusheva A.V., Moiseeva I.E. Malnutrition in the elderly and senile age // Russian Family Doctor. 2019 ; 23(1) : 5-15. (In Russ.).] doi: https://doi.org/10.17816/RFD201915-15.

59. Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Hooper L, et al. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022;41(4):958-989. doi: https://doi.org/10.1016/j.clnu.2022.01.024

60. Rehabilitation after hip arthroplasty in a specialized hospital department. Federal clinical guidelines. // Bulletin of Restorative Medicine. 2016 ; 5 (75) : 94-102. (In Russ.)

61. Mitchell P, Âkesson K, Chandran M, Cooper C, Ganda K, Schneider M. Implementation of Models of Care for secondary osteoporotic fracture prevention and orthogeriatric Models of Care for osteoporotic hip fracture. Best Pract Res Clin Rheumatol. 2016;30(3):536-558. doi: https://doi.org/10.1016/j.berh.2016.09.008

62. Ganda K, Puech M, Chen JS, Speerin R, Bleasel J, et al. Models of care for the secondary prevention of osteoporotic fractures: a systematic review and meta-analysis. Osteoporos Int. 2013;24(2):393-406. doi: https://doi.org/10.1007/s00198-012-2090-y

63. Falls in elderly and senile patients. Clinical guidelines, 2020. (In Russ.). Режим доступа: https://cr.minzdrav.gov.ru/preview-cr/600_2, свободный.

64. Gittoes N, McLellan AR, Cooper A, Dockery F, Davenport G, Goodwin V, et al. Effective Secondary Prevention of Fragility Fractures: Clinical Standards for Fracture Liaison Services. Camerton: National Osteoporosis Society, 2015

65. Belova K.Y., Lesnyak O.M., Evstigneeva L.P., [et al.]. Comments on the use of Key Performance Indicators in evaluating the Organization of Fracture Liaison Services. Osteoporosis and Bone Diseases. 2022 ; 25 (4) : 28-42. (In Russ.). doi: https://doi.org/10.14341/osteo12960.

66. Ratnasamy PP, Rudisill KE, Oghenesume OP, Riedel MD, Grauer JN. Risk of Contralateral Hip Fracture Following Initial Hip Fracture Among Geriatric Fragility Fracture Patients. J Am Acad Orthop Surg Glob Res Rev. 2023;7(7):e23.00001. doi: https://doi.org/10.5435/JAAOSGlobal-D-23-00001

67. Wang CY, Fu SH, Yang RS, Chen LK, Shen LJ, Hsiao FY. Timing of antiosteoporosis medications initiation after a hip fracture affects the risk of subsequent fracture: A nationwide cohort study. Bone. 2020;138:115452. doi: https://doi.org/10.1016/j.bone.2020.115452

68. Kochish A.Yu., Lesnyak O.M. Prevention of repeated bone fractures in patients with osteoporosis // Osteoporosis / edited by O.M. Lesnyak : GEOTAR-Media, 2016. P. 446-462. (In Russ.). ISBN: 978-5-9704-3986-9.

69. Kochish A.Yu., Mironenko A.N., Lasunsky S.A., Stafeev D.V. Possibilities of pharmacological correction of postmenopausal osteoporosis in patients with extra-articular fractures of the proximal femur // Traumatology and Orthopedics of Russia. 2011 ; 17 (2) : 50-56. (In Russ.) doi: 10.21823/2311-2905-2011-0-2-50-56

70. Lyles KW, Colon-Emeric CS, Magaziner JS, Adachi JD, Pieper CF, et al. HORIZON Recurrent Fracture Trial. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357(18):1799-809. doi: https://doi.org/10.1056/NEJMoa074941

71. Koutalos AA, Chalatsis GI, Varsanis G, Malizos KN, Karachalios T. The effect of zoledronic acid and high-dose vitamin D on function after hip fractures. A prospective cohort study. Eur J Orthop Surg Traumatol. 2022;32(6):1145-1152. doi: https://doi.org/10.1007/s00590-021-03092-z

72. Jalbert R, Blain H, Boudissa M, Bioteau C, Parent T, et al. Zoledronic Acid Contraindications Prevalence among Hip-Fractured Patients Aged 75 Years or Over Hospitalized in an Orthogeriatric Unit. Gerontology. 2022;21:1-9. doi: https://doi.org/10.1159/000520999

73. Kashii M, Kamatani T, Abe S, Yoshida A, Yamamoto K, et al. Tolerability of the first infusion of once-yearly zoledronic acid within one to two weeks after hip fracture surgery. Bone. 2022;155:116298. doi: https://doi.org/10.1016/j.bone.2021.116298

74. Malgo F, van Deudekom FJA, Hup R, Formijne Jonkers HA, Kempen DHR, et al. Inpatient zoledronic acid in older hip fracture patients is well tolerated and safe. Arch Osteoporos. 2024;19(1):96. doi: https://doi.org/10.1007/s11657-024-01453-9

75. Silverman SL, Kupperman ES, Bukata SV. Members of IOF Fracture Working Group. Fracture healing: a consensus report from the International Osteoporosis Foundation Fracture Working Group. Osteoporos Int. 2016;27(7):2197-2206. doi: https://doi.org/10.1007/s00198-016-3513-y

76. Chandran M, Akesson KE, Javaid MK, Harvey N, Blank RD, et al. Fracture Working Group of the Committee of Scientific Advisors of the International Osteoporosis Foundation, on behalf of the International Osteoporosis Foundation, Societe Internationale de Chirurgie Orthopedique et de Traumatologie. Impact of osteoporosis and osteoporosis medications on fracture healing: a narrative review. Osteoporos Int. 2024;35(8):1337-1358. doi: https://doi.org/10.1007/s00198-024-07059-8

77. Johansen A, Sahota O, Dockery F, Black AJ, MacLullich AMJ, et al. Call to action: a five nations consensus on the use of intravenous zoledronate after hip fracture. Age Ageing. 2023;52(9):afad172. doi: https://doi.org/10.1093/ageing/afad172. Erratum in: Age Ageing. 2024 Jan 2;53(1):afae014. doi: https://doi.org/10.1093/ageing/afae014

78. Li YT, Cai HF, Zhang ZL. Timing of the initiation of bisphosphonates after surgery for fracture healing: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int. 2015;26(2):431-41. doi: https://doi.org/10.1007/s00198-014-2903-2

79. Tong YYF, Holmes S, Sefton A. Early bisphosphonate therapy post proximal femoral fracture fixation does not impact fracture healing: a systematic review and meta-analysis. ANZ J Surg. 2022;92(11):2840-2848. doi: https://doi.org/10.1111/ans.17792

80. Schäfer ST, Andres C. Update zu ,,Fast-track”-Konzepten in der operativen Medizin : Verbessertes Outcome und höhere Patientenzufriedenheit durch interdisziplinare, multimodale Behandlungskonzepte [Update on fast-track concepts in operative medicine : Improved outcome and higher patient satisfaction through interdisciplinary multimodal treatment concepts]. Anaesthesiologie. 2023;72(2):81-88. German. doi: https://doi.org/10.1007/s00101-022-01234-4

81. Tkacheva O.N., Runikhina N.K., Kotovskaya Yu.V., et al. Clinical Guidelines for Perioperative Care of Older and Oldest-Old Patients Living with Frailty Undergoing Elective Surgery. Russian Journal of Geriatric Medicine. 2023 ; 16 (4) : 218-232. (In Russ.) doi: https://doi.org/10.37586/2686-8636-4-2023-218-232

82. On approval of the Regulation on the organization of palliative medical care, including the procedure for interaction between medical organizations, social service organizations and public associations, other non-profit organizations operating in the field of health care. Order of the Ministry of Health of the Russian Federation, the Ministry of Labor and Social Protection of the Russian Federation dated May 31, 2019 No. 345n/372n. (In Russ.). Режим доступа: http://publication.pravo.gov.ru/Document/View/0001201906270031, свободный.

83. Reyes BJ, Mendelson DA, Mujahid N, Mears SC, Gleason L, et al. Postacute Management of Older Adults Suffering an Osteoporotic Hip Fracture: A Consensus Statement From the International Geriatric Fracture Society. Geriatr Orthop Surg Rehabil. 2020;11:2151459320935100. doi: https://doi.org/10.1177/2151459320935100

84. Amarilla-Donoso FJ, Roncero-Martm R, Lavado-Garcfa J, Canal-Maaas ML, Pedrera-Canal M, et al. Impact of a Postoperative Intervention Educational Program on the Quality of Life of Patients with Hip Fracture: A Randomized, Open-Label Controlled Trial. Int J Environ Res Public Health. 2020;17(24):9327. doi: https://doi.org/10.3390/ijerph17249327

85. Kalem M, Kocaoğlu H, Duman B, Şahin E, Yoğun Y, Ovali SA. Prospective Associations Between Fear of Falling, Anxiety, Depression, and Pain and Functional Outcomes Following Surgery for Intertrochanteric Hip Fracture. Geriatr Orthop Surg Rehabil. 2023;14:21514593231193234. doi: https://doi.org/10.1177/21514593231193234

86. Noeske KE, Snowdon DA, Ekegren CL, Harding KE, Prendergast LA, et al. Walking self-confidence and lower levels of anxiety are associated with meeting recommended levels of physical activity after hip fracture: a cross-sectional study. Disabil Rehabil. 2024:1-7. doi: https://doi.org/10.1080/09638288.2024.2338195

87. On approval of the Qualification requirements for medical and pharmaceutical workers with higher education. Order of the Ministry of Health of the Russian Federation dated 02.05.2023 No. 206n. (In Russ.). Режим доступа: http://publication.pravo.gov.ru/document/0001202306010041, свободный.

88. Gimigliano F, Liguori S, Moretti A, Toro G, Rauch A, et al. Systematic review of clinical practice guidelines for adults with fractures: identification of best evidence for rehabilitation to develop the WHO's Package of Interventions for Rehabilitation. J Orthop Traumatol. 2020;21(1):20. doi: https://doi.org/10.1186/s10195-020-00560-w. Erratum in: J Orthop Traumatol. 2021;22(1):7

89. Bennett MJ, Center JR, Perry L. Exploring barriers and opportunities to improve osteoporosis care across the acute-to-primary care interface: a qualitative study. Osteoporos Int. 2023;34(7):1249-1262. doi: https://doi.org/10.1007/s00198-023-06748-0

90. Yeam CT, Chia S, Tan HCC, Kwan YH, Fong W, Seng JJB. A systematic review of factors affecting medication adherence among patients with osteoporosis. Osteoporos Int. 2018;29(12):2623-2637. doi: https://doi.org/10.1007/s00198-018-4759-3

91. Hiligsmann M, McGowan B, Bennett K, Barry M, Reginster JY. The clinical and economic burden of poor adherence and persistence with osteoporosis medications in Ireland. Value Health. 2012;15(5):604-12. doi: https://doi.org/10.1016/j.jval.2012.02.001

92. Bennett MJ, Center JR, Perry L. Establishing consensus recommendations for long-term osteoporosis care for patients who have attended an Australian fracture liaison service: a Delphi study. Osteoporos Int. 2024;35(3):373-389. doi: https://doi.org/10.1007/s00198-024-07014-7

93. Bennett KA, Ong T, Verrall AM, Vitiello MV, Marcum ZA, Phelan EA. Project ECHO-Geriatrics: Training Future Primary Care Providers to Meet the Needs of Older Adults. J Grad Med Educ. 2018;10(3):311-315. doi: https://doi.org/10.4300/JGME-D-17-01022.1