Proximal femoral fracture: achievements and prospects.

Patients with proximal femoral fracture occupy 20% of all orthopaedic beds at any one time [1]. In postmenopausal women, proximal femoral fracture accounts for more bed days annually than breast cancer, acute myocardial infarction, diabetes mellitus or chronic obstructive pulmonary disease. Most people with a proximal femoral fracture are old: 90% are older than 65 and 75% are older than 75. Most are women: one in six women who reach the age of 80 years will suffer a hip fracture [2, 3]The incidence is rising, partly because of the ageing population, but the agerelated fracture rate is also increasing [4], which may be related to smoking and a more sedentary lifestyle. Although treated on orthopaedic wards, patients with proximal femoral fracture frequently have complex problems. Eighty percent have hypertension, diabetes mellitus, Parkinson's disease or dementia [5].