Anesthésie pour fracture du col fémoral chez le sujet âgé

Femoral neck fracture is a public health issue in elderly women because of its high incidence, which impacts heavily their life expectancy. If cardiovascular complications are the leading cause of mortality, the systematic practice of complementary examinations has a deleterious effect by delaying the response. Response time shall be limited to less than 48 hours and must not be extended by investigations that will not change the perioperative support. The choice of regional or general anesthesia has not impact on morbidity and mortality. In patients suffering from ischemic heart disease, transfusion threshold should be increased to 10 g/L. Prosthetics without cement appear as reliable and efficient than cemented prostheses, which convey an increase risk of embolism of femoral content. Postoperative cognitive dysfunction is one of the main postoperative complications. Thromboprophylaxis must be established early in view of the high rate of venous thrombosis. A postoperative rehabilitation program must be implemented.