Geriatric Hip Fractures in Rural America: A Review of Barriers and Proposed Solutions

Document Type

Article

Publication Date

8-2026

Publication Title

Journal of Orthopaedic Reports

Abstract

Introduction: Hip fractures are a common cause of geriatric orthotrauma. As the population ages, hip fractures will inevitably require greater resource allocation, compounding the strain on already burdened rural healthcare systems. Not only are geriatric hip fractures more prevalent in rural communities, they are associated with higher patient morbidity and mortality compared to their urban counterparts.  Objective: The following review explores the current landscape of geriatric hip fractures in rural communities and highlights the unique challenges that rural patients and hospitals face in reaching definitive operative management. Barriers to Care: Key barriers to care include delayed time-to-surgery, shortage of rural orthopaedic surgeons, resource limitations, and financial constraints. Solutions: This review discusses potential solutions aimed to improve rural geriatric hip fracture outcomes, including telemedicine, standardized decision making pathways, ortho-geriatric co-management models, expanding the rural orthopaedic workforce, financial incentives, and hip fracture prevention. These actionable, pragmatic solutions seek to improve time-to-surgery and post-operative outcomes, closing the gap between rural and urban geriatric hip fracture morbidity and mortality.

Volume

5

Issue

4

First Page

100811

Last Page

100811

DOI

10.1016/j.jorep.2025.100811

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