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 .
Why are we still using pre-operative skin traction for hip fractures?
Abstract . We performed a prospect i ve r and omised trial to evaluate the efficacy of  pre-operative skin traction  for proximal femoral fractures in 311 patients . We found a significant difference in pain score on the evening of admission and the first morning after admission between the groups with traction compared the group without . However , there was no corresponding increase in analgesic requirement during this period . The peak pain score pattern also was different in our population . No other objective benefit can be shown from using skin traction , and its routine use should be ab and oned . Résumé . Nous avons mené une étude prospect i ve et r and omisée pour évaluer l'efficacité de la traction cutanée préopératoire pour les fractures fémorales proximales chez 311 malades . Nous avons trouvé une différence notable dans le score de la douleur le soir de l'admission et le premier matin après l'admission entre le groupe avec traction comparé au groupe sans traction . Cependant , il n'y avait pas d'augmentation correspondante de la nécessité d'analgésiques pendant cette période ou la douleur était cotée au plus haut . Aucun autre avantage objectif d'utiliser la traction cutanée n'a été montré et son usage habituel devrait être ab and onné
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 .