{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T02:17:08Z","timestamp":1788315428993,"version":"build-2803163510"},"reference-count":173,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Hip fractures pose a serious threat to the quality of life among older adults and impose a heavy burden on both society and families. Although current surgical techniques for hip fractures have become increasingly refined, postoperative quality of life and overall function in older adult populations often steeply decline. This decline is marked by \u201csecondary debilitation,\u201d characterized by exacerbated sarcopenia, functional impairment, and physiological reserve depletion\u2014a process that becomes a risk factor for recurrent fractures, creating a \u201cvicious cycle\u201d with hip fractures. This article provides a comprehensive overview of the pathophysiological mechanisms underlying \u201csecondary debilitation,\u201d discusses the clinical application of risk assessment tools, and presents a phased, stepwise intervention strategy aimed at interrupting the \u201cvicious cycle.\u201d The strategy includes early rapid rehabilitation, nutritional support, and prevention of complications; a mid\u2010phase multimodal approach involving multidisciplinary management, comanaged wards, fracture liaison services, and systematic rehabilitation; and, finally, late\u2010phase exploration of emerging pharmacotherapies and treatment methods. This review seeks to offer an evidence\u2010based foundation for optimizing clinical risk assessment and developing precise interventional strategies.<\/jats:p>","DOI":"10.1111\/os.70375","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:01:11Z","timestamp":1785128471000},"page":"1785-1803","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Breaking the Debilitating Cycle: Pathophysiology, Assessment, and Multimodal Intervention of Secondary Debilitation After Hip Fracture in Older Adults\u2014A Narrative Review"],"prefix":"10.1111","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4657-9078","authenticated-orcid":false,"given":"Wenyang","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Trauma Honghui Hospital, Xi'an Jiaotong University  Xi'an Shaanxi China"},{"name":"Xi'an Medical University  Xi'an Shaanxi 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