Hip Fracture

Hip Fractures are typically caused by falls, and the risk for Hip Fractures increases with age. Older adults, more specifically, those over the age of 85, are at the highest risk. Medical complications from hip fractures can be life threatening, especially for older adults. It’s imperative that you seek medical care immediately if you suspect you have a hip fracture.

Anatomy

The hip joint is a ball-in-socket joint. The pelvis bone has a cup-shaped socket, called the Acetabulum, that is responsible for holding the top of our thigh bone in place. It also allows it to rotate during movement. The top of the Femur, the Femoral Head, is shaped like a ball. The Acetabulum and the Femoral Head come together, forming our hip joint.

The Femoral Head and Femur are attached by small section of bone called the Femoral Neck, which attaches to the Femur between two projections of bone,Greater Trochanter and the Lesser Trochanter. The long length of bone on the femur, commonly called the thigh-bone, is the Shaft.

The primary function of the Hip Joint is to support the weight of our upper body. The joint provides a base of support, allowing us to hold our body upright when we sit or stand. It also provides stability for our upper body as well as positioning the lower body to move. The Hip Joint allows the legs to move in all directions as well as to rotate inward and outward. Every time you place your feet on the ground, you rotate your legs.  

Hip Fracture Causes

A Hip Fracture is almost always caused by trauma. This happens when the top part of the Femur breaks. As previously mentioned, falls are the most common cause of Hip Fractures in older adults, and the risk increases with age. Any source of high force trauma, can cause Hip Fractures at any age.

On average, women experience more Hip Fractures than men. Also, women have higher rates of bone density loss from Osteoporosis. For both women and men, bone density generally starts to decrease after the age of 50.

Falls are the leading cause of general injuries for older adults. The specific type of fall that usually causes a hip injury often takes place on a level surface.This is as opposed to falling down a flight of stairs.

Sometimes, the side effects or interactions from medication can cause balance problems associated with falls, especially with older adults. Older adults that take multiple medications or certain types of medications have the highest risk of falling.

Some medical conditions are often associated with an increased risk for falls, including:

  • Parkinson’s disease
  • Stroke
  • Arthritis
  • Any diagnoses that causes a change in thought processing or vision

Hip Fracture Symptoms

A Femur break is painful and increases when you attempt to move your thigh. An individual with a broken femur may not be able to stand or put weight on the leg. The leg may turn outward at an extreme angle, and in some cases may appear to be shorter than the other leg. If you suspect that you fractured your hip, you need to get medical treatment immediately.

Hip Fracture Diagnosis

The doctor will make a diagnosis by examination and order X-rays to confirm a Hip Fracture. X-rays will provide a good picture of the bones in the hip joint, showing exactly where the Femur broke and how far out of place the pieces have moved.

Hip Fractures are classified by the fracture location. The most common fractures are:

  • Femoral Neck Fractures
  • Intertrochanteric Fractures
  • Subtrochanteric Fractures.

Hip Fracture Treatment

Hip Fracture treatment typically involves surgery. The only rare exception is for those individuals that cannot tolerate the risks associated with anesthesia. In a very few cases, the fracture is allowed to heal while the individual remains in bed for several weeks. This is extremely risky because of the development of other significant medical problems.

Hip Fracture Surgery

Hip Fracture surgery varies per individual. The type of surgery will depend on the location of the fracture. The surgery should take place as soon as you are medically stable. This is an in-patient surgery, that will always require hospitalization. The patient is admitted to the hospital for the surgery and can expect to spend a few days there while he or she recovers.

The patient will either have spinal or general anesthesia for the surgery. The surgeon will make an incision at the hip and realign the broken bones. This procedure is called an Open Reduction. The surgeon uses surgical hardware, Internal Fixators, to hold the bones in place while they heal. This procedure is called an Open Reduction and Internal Fixation, or ORIF.

The type of surgical hardware that is used depends on the type of fracture.

Hip Fracture Recovery

Just like the surgery, the recovery process from hip surgery varies by individual. In general, it takes about six to eight weeks for a hip fracture to heal. However, it’s important to note that the full recovery takes much longer. Usually a walker or crutches are required while the patient is standing and walking. The doctor will instruct as to how much weight can be put on the foot, and then will follow up with X-rays to see how the bones have healed.

After the recovery period, both Occupational and Physical Therapists will be there to guide the patient with exercises to help strengthen the hip and increase balance, giving body positions to protect the hip while it heals. It is usually recommended to invest in durable medical equipment for the home, such as a raised toilet seat or a shower chair. Sometimes this can even be covered by the patient’s insurance.

Hip Fracture Prevention

By reducing the risk of falls, you can reduce the risk of a Hip Fracture. Keeping a good schedule of physical exams, bone density tests, and eye exams could identify medical conditions that are associated with dizziness or loss of balance, especially after the age of 50. If you believe you are susceptible to falls and live alone,it is advised to wear a medical alert device to call for emergency help if needed.

Being proactive can also help. Consider installing railings on steps or in the shower. Durable medical equipment, such as toilet seat risers and shower chairs, can help maintain independence for older adults.

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