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NICE Guidance
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Musculoskeletal conditions
Fractures
Fractures
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Research Recommendations
Imaging options in occult hip fracture:- In patients with a continuing suspicion of a hip fracture but whose radiographs are ...
Anaesthesia:- What is the clinical and cost effectiveness of regional versus general anaesthesia on postoperative morbidity i...
Displaced intracapsular hip fractures:- What is the clinical and cost effectiveness of large-head total hip replacement versu...
Intensive rehabilitation therapies after hip fracture:- What is the clinical and cost effectiveness of additional intensive p...
Early supported discharge in care home patients:- What is the clinical and cost effectiveness of early supported discharge on...
Using GP practice lists to identify people at high risk:- What is the clinical and cost effectiveness of using GP practice li...
September 2012
FRAX and QFracture in adults receiving bone protective therapy:- What is the utility of FRAX and QFracture in adults receivin...
September 2012
FRAX and QFracture in adults with secondary causes of osteoporosis:- What is the utility of FRAX and QFracture in detecting r...
September 2012
Bone mineral density (BMD) with FRAX:- What is the added prognostic value of BMD in the assessment of fracture risk with FRAX...
September 2012
FRAX and QFracture in adults living in residential care:- What is the utility of FRAX and QFracture in detecting risk of frag...
September 2012
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Shared Learning
Use of the EXOGEN ultrasound bone healing system for delayed and non-unions
January 2014
Do not do
Analgesia: Non-steroidal anti-inflammatory drugs (NSAIDs) are not recommended as pain relief for patients with hip fracture.
June 2011
Do not routinely assess fracture risk in people aged under 50 years unless they have major risk factors (for example, current or frequent recent use of oral or systemic glucocorticoids, untreated premature menopause or previous fragility fracture), because they are unlikely to be at high risk.
August 2012
Do not routinely measure bone mineral density (BMD) to assess fracture risk without prior assessment using FRAX (without a BMD value) or Qfracture. FRAX is the World Health Organisation fracture risk assessment tool, which can be used for people aged between 40 and 90 years, either with or without BMD values, as specified.
August 2012
Do not offer non-steroidal anti-inflammatory drugs (NSAIDs) to frail or older adults with fractures.
May 2016
Do not use gas and air (nitrous oxide and oxygen) on its own when reducing dorsally displaced distal radius fractures in the emergency department.
May 2016
Do not use a rigid cast for torus fractures of the distal radius.
May 2016
Do not irrigate open fractures of the long bones, hindfoot or midfoot in pre-hospital settings.
May 2016
Do not rely on capillary return or Doppler signal to exclude vascular injury.
May 2016
Do not routinely use whole-body CT to image children (under 16s). Use clinical judgement to limit CT to the body areas where assessment is needed.
May 2016
Do not log roll people with suspected pelvic fractures before pelvic imaging unless: an occult penetrating injury is suspected in a person with haemodynamic instability, log rolling is needed to clear the airway (for example, suction is ineffective in a person who is vomiting).
May 2016
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