Overall , moderate evidence suggests that nerve blockades are effective for relieving acute pain and reducing delirium .
Low-level evidence suggests that preoperative traction does not reduce acute pain .
Nerve blockade seems to be effective in reducing acute pain after hip fracture .
Sparse data preclude firm conclusions about the relative benefits or harms of many other pain management interventions for patients with hip fracture .
BACKGROUND  Pain management  is integral to the management of hip fracture .
PURPOSE To review the benefits and harms of pharmacologic and nonpharmacologic interventions for managing pain  after hip fracture .
Preoperative traction for hip fracture: a randomized comparison between skin and skeletal traction in 78 patients.
153 consecutive patients with displaced cervical and trochanteric hip fractures were considered for inclusion in this study . 75 were excluded because of senile confusion and the remaining 78 were r and omized to skeletal or skin traction  preoperatively . The effect on pain alleviation was evaluated with a Visual Analogue Scale ( VAS ) and by the number of doses of analgesics  administered . The processing time through the emergency department , radiographic department and to the ward , as well as time to operation , was registered . No significant difference in the VAS pain evaluation was found . There was a small significant increase in consumption of analgesics of no clinical importance in patients with skin traction , and no effect of traction type on the processing time or time to operation . Fracture type did not affect the outcome . Since half of the patients found the application of skeletal traction painful , compared to one fifth with skin traction , skeletal traction should not be routinely used to alleviate pain preoperatively in these patients
Overall , moderate evidence suggests that nerve blockades are effective for relieving acute pain and reducing delirium .
Low-level evidence suggests that preoperative traction does not reduce acute pain .
Nerve blockade seems to be effective in reducing acute pain after hip fracture .
Sparse data preclude firm conclusions about the relative benefits or harms of many other pain management interventions for patients with hip fracture .
BACKGROUND  Pain management  is integral to the management of hip fracture .
PURPOSE To review the benefits and harms of pharmacologic and nonpharmacologic interventions for managing pain  after hip fracture .