{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:10:38Z","timestamp":1788966638747,"version":"build-2803163510"},"reference-count":37,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["HIP International"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Hip fractures cause significant morbidity and mortality worldwide, a burden expected to rise with population ageing. Operative management remains the mainstay of treatment; however, a small number of patients receive non-operative treatment. The Australian and New Zealand Hip Fracture Registry (ANZHFR) began recording reasons for non-operative management in 2021. The study aimed to identify factors influencing the decision for non-operative management, compare outcomes between operative and non-operative treatment and compare palliative patients who died \u2a7d30\u2009days to those who survived &gt;30\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using ANZHFR data between 01 January 2021 and 31 December 2022, including patients aged \u2a7e50\u2009years with a hip fracture. Patients were categorised as: operative or non-operative, the latter sub-categorised; palliative, not clinically indicated, or other. Demographic, clinical and fracture characteristics, length of stay, discharge destination and mortality at 30, 120 and 365\u2009days were compared. A sub-analysis of the palliative group compared those who survived &gt;30\u2009days with those who died \u2a7d30\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 31,423 hip fracture patients, 30,734 (97.8%) underwent surgery, and 689 (2.2%) were managed non-operatively (438 palliative, 127 surgery not clinically indicated, 124 other). Palliative patients were older, frailer, less mobile, more likely to live in residential aged care, and to have dementia. Men and patients treated in Tasmania were more likely to receive palliative care. Non-displaced valgus impacted fractures were more common among the not clinically indicated group. 30-day mortality was highest in the palliated group (87.2%) and lowest in the operative group (7.3%). Age was the only factor associated with survival &gt;30\u2009days among palliated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This is the first registry-based analysis of non-operative hip fracture management by reason. It identified distinct demographic, clinical and geographical patterns that influenced non-operative care. The palliative cohort had the highest mortality; however, a small proportion of patients survived.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/11207000251408435","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T09:00:21Z","timestamp":1771318821000},"page":"627-636","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["What is the place for non-operative management of neck of femur fractures: analysis of the Australia and New Zealand Hip Fracture Registry (ANZHFR)"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5587-501X","authenticated-orcid":false,"given":"Carla","family":"Davies","sequence":"first","affiliation":[{"name":"Fiona Stanley Hospital, Murdoch, WA, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara","family":"Harvey","sequence":"additional","affiliation":[{"name":"Neuroscience Research Australia, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Health and Human Sciences, Australian Institute of Health Innovation, Maquarie University, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Sarkies","sequence":"additional","affiliation":[{"name":"Sydney School of Health Services, Faculty of Medicine and Health, University of Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Navarre","sequence":"additional","affiliation":[{"name":"Southland Hospital, Invercargill, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Wall","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Toowoomba Hospital, Darling Downs Health, Toowoomba, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/CORR.0000000000002465"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.4821"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-023-06907-3"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/berh.2002.0264"},{"key":"e_1_3_3_6_2","unstructured":"Australia and New Zealand Hip Fracture Registry. ANZHFR. Problem https:\/\/anzhfr.org (2021 accessed 25 October 2024)."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/TME.0000000000000180"},{"key":"e_1_3_3_8_2","unstructured":"Australian and New Zealand Hip Fracture Registry. 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ANZHR data dictionary Version 16. Sydney Australia: Australia and New Zealand Hip Fracture Registry ANZHFR-DataDictionary_v16_November-2023_FINAL.pdf (2024 accessed 29 October 2024)."},{"key":"e_1_3_3_21_2","volume-title":"StatPearls","author":"Mendiratta P","year":"2023","unstructured":"Mendiratta P, Schoo C, Latif R. Clinical frailty scale. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing, 2023."},{"key":"e_1_3_3_22_2","unstructured":"Stanford Medicine Health Care. What are the different types of hip fracture? https:\/\/stanfordhealthcare.org\/medical-conditions\/bones-joints-and-muscles\/hip-fracture\/types.html (2024 accessed 13 November 2024)."},{"key":"e_1_3_3_23_2","volume-title":"StatPearls","author":"Emmerson BR","year":"2023","unstructured":"Emmerson BR, Varacallo M, Inman D. Hip fracture overview. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing, 2023. 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