Improving Pain and Function in Hip Fracture

Inclusion Criteria:

- All adult patients 60 years of age and over that present to the MSMC ED from 8:00 to
20:00 with a radiographically confirmed hip fracture (femoral neck,
intertrochanteric, or peri-capsular) will be screened for study eligibility.

Exclusion Criteria:

- History of advanced dementia

- Presence of multiple trauma, pathological fractures, bilateral hip fractures, or
previous fracture or surgery at the currently fractured site

- Patients transferred from another hospital

- Patients with cirrhosis or liver failure.

- The investigators exclude patients with advanced dementia because the investigators
will require patients to self-report their pain intensity.

- The investigators exclude these categories of hip fracture because they represent
patients with atypical or often problematic clinical circumstances.

- The investigators exclude patients under age 60 because our focus is on treatment of
pain in older adults. Younger adults (less than age 60) typically present with
fractures of different cause (severe and multiple trauma), are less sensitive to the
side effects and complications of opioid therapy, are less likely to have delayed or
prolonged functional recovery, and are less sensitive to the adverse and sometimes
permanent effects of prolonged bed rest (i.e., from pain) on function.

- The investigators exclude patients with hepatic dysfunction because the intervention
protocol includes administration of acetaminophen which can provoke liver failure in
patients with advanced liver disease.