Today, the standard treatment is to operate on patients suffering from a fracture of the upper end of the femur. The aim of treatment is to enable immediate mobilization and weight-bearing, and as rapid a return as possible to normal living conditions.

Surgery is the best treatment option. It maximizes the chances of functional recovery and, by stabilizing the fracture, reduces pain: it is the most effective and longest-lasting analgesic.

Adequate analgesia in elderly patients with femoral neck fractures has a beneficial effect. In particular, a lower probability of death has been shown in cervical fracture patients receiving opioids than those not receiving them.

Pain management is a matter of protocol in the UPOG department of the CHU de Nîmes.

Pain prevention appears to improve morbidity and mortality. Cognitive fragility, such as neurocognitive disorders, confusion or long-term use of psychotropic drugs, appear to be confounding factors in pain management.

The investigators therefore wished to observe whether the presence of cognitive fragility has an impact on pain management on the ward, despite protocol-based management.

Inclusion Criteria:

• Patients aged > 75 years
• Hospitalized for a fracture of the upper extremity of the femur at the UPOG of the CHU de Nîmes during 2022

Exclusion Criteria:

• Opioid allergy
• No surgical management of fracture
• Long-term treatment with high-dose opiates
• Patient has objected to the use of his or her data.

All patients hospitalized at UPOG for fracture of the upper end of the femur between January 1 and December 31, 2022.