What are Hip Fractures?
A hip fracture is a partial or complete break of the femur (thigh bone) where it meets the pelvis in the hip joint. It is a serious injury that most often requires surgery. Fractured hips in young people usually occur in car accidents or other severe trauma. However, the majority of hip fractures occur in people over the age of 60 following a mechanical fall.
Risk Factors
Hip fractures generally occur as you grow older due to the bones becoming weaker and thinner. When bone is lost too quickly and becomes too weak, osteoporosis can develop and increase the risk of hip fracture. Diminished estrogen, commonly found in postmenopausal women, makes one more susceptible to fracture as well. In fact, almost 70% of hip fractures occur in women.
Preventing Hip Fractures
Avoiding a hip fracture if possible is important. There are many things which can decrease your likelihood of having a hip fracture including consuming enough vitamin D and calcium, getting a bone density test, taking medications to prevent bone loss if prescribed, engaging in regular exercise, stopping smoking, keeping floors and stairs clear of hazards, using slip-resistant rugs, using night lights for bathrooms and hallways, and avoiding unsteady furniture or ladders.
Symptoms
You may experience pain and swell around the hip or thigh. Other symptoms include an inability to walk or stand, bruising, and sometimes even deformity.
Diagnosis
Diagnosis involves a doctor’s examination followed by an X-ray. Sometimes additional imaging studies such as CT scan, MRI, or bone scan may be necessary. Blood and lab tests may also be ordered. Hip fractures most commonly occur in the femoral neck, intertrochanteric, or subtrochanteric areas of the femur (thigh bone). Your surgeon will let you know which applies to you.
Treatment
Hip fractures are usually treated surgically, under general or regional anesthesia. The surgical procedure may be any of the following:
Internal repair and placement of hardware: Depending on the fracture location and characteristics, some hip fractures can be treated with the placement of screws, plates, and/or a rod placed inside of the bone.
Total hip replacement: Other types of hip fractures are treated by replacing both the ball (femur) and socket (pelvis) with artificial metal and plastic parts.
Partial hip replacement: In other situations, sometimes only the ball (femur) needs to replaced, and the socket (pelvis) can be left alone.
After Surgery
You will likely have to stay in the hospital for a few days before being discharged. After surgery you will receive pain medications for recovery as well as a blood-thinning medication to minimize the risk of clots. Additional medications such as antibiotics, a stool softener, and anti-nausea medication are also commonly prescribed. You will work with therapy while you are in the hospital to be begin the recovery and rehabilitation process. How you recover in the hospital will help determine if you are safe to return to your own home, or if you might need to transition to a rehabilitation hospital or extended care facility of some type.
Rehabilitation
Your surgeon may suggest dedicated physical therapy and rehabilitation. This will focus on range of motion, strengthening, and gait training. In addition, you will work on techniques for regaining independence in activities of daily living such as using the bathroom, dressing, and cooking. Depending on the type of surgery and needs of recovery, this may require going to an extended care facility of some type.
