Hip Fracture


Hip Fracture

A hip fracture is a serious medical condition that involves a break in the upper part of the femur (thigh bone) near the hip joint. It can be a debilitating injury, especially for older adults, and often requires surgery to heal properly. Hip fractures may be:  

  1. Intracapsular fracture: This break occurs within the joint capsule around the head of the femur. 
  2. Intertrochanteric fracture: This break occurs between the greater and lesser trochanters (bony bumps) on the top of the femur. 
  3. Subtrochanteric fracture: This break occurs below the femur shaft, below the lesser trochanter. 

Intracapsular fractures are more common in older adults with osteoporosis, whereas intertrochanteric and subtrochanteric fractures can occur in individuals of various ages due to falls or high-energy impacts. 

What are the causes ?

The most common cause of hip fracture is a fall, especially from standing at a height or more. This is especially true for older adults whose bones are weakened by osteoporosis. 

Other possible causes of hip fracture include: 

  1. Motor vehicle accidents: High-energy impacts from car accidents or other accidents can cause hip fractures in people of any age. 
  2. Certain medical conditions: Osteoporosis, a condition that weakens the bones, significantly increases the risk of hip fracture. Other conditions such as Paget’s disease of bone or bone tumors can also weaken bones and contribute to fracture risk. 
  3. Medications: Long-term use of corticosteroids (steroid medications) can weaken bones and increase the risk of fractures. 

What are the Signs and symptoms?

The most common symptom of a hip fracture is severe pain in the hip or groin, often described as: 

Predisposing factors for Hip Fracture

Some factors can increase the risk of hip fracture: 

  1. Age: The risk of hip fracture increases significantly with age, especially for people over the age of 65. 
  2. Osteoporosis: This bone-weakening condition makes bones more susceptible to fractures, even from minor falls. 
  3. Previous Fractures: Individuals with a history of fractures are at increased risk of future fractures, including hip fractures. 
  4. Poor balance and gait: Difficulty maintaining balance or unsteady gait can increase the risk of falls and subsequent hip fractures. 
  5. Muscle weakness: Weak leg and core muscles can impair balance and stability, leading to falls. 
  6. Vision problems: Vision impairment can increase the risk of tripping and falling. 
  7. Certain medications: Sedatives or blood thinners can increase the risk of falls and fractures. 

Diagnosis of Hip Fracture

Diagnosis of a hip fracture usually includes: 

  1. Physical examination: A health care professional will evaluate the hip joint for pain, tenderness, swelling, and bruising. They will also test your ability to move your leg and bear weight. 
  2. X-rays: X-rays are the gold standard for diagnosing hip fractures. They can clearly see the location and type of fracture. 
  3. CT scan: This can provide a more detailed 3D image of the bone and surrounding structures, which can be helpful in complex fracture patterns. 
  4. MRI scan: This is not routinely used to diagnose hip fractures but may be helpful in identifying soft tissue injuries or bony injuries in the area. 

Based on the medical history, physical examination, and X-ray findings, the health care professional will confirm the diagnosis of hip fracture and recommend the most appropriate treatment. 

Hip fracture treatment options

Surgery is usually the primary treatment for hip fractures. The specific surgical approach depends on the location and type of fracture. Here is an overview of common surgical procedures for hip fractures: 

  1. Internal fixation: This involves the use of screws, pins, or plates to hold broken bone fragments together so they can heal. It is usually preferred for younger patients or those with good bone health. 
  2. Hemiarthroplasty (partial hip replacement): In some cases, especially for intracapsular fractures or fractures with significant damage to the femoral head, partial hip replacement may be necessary. This surgery replaces the damaged femoral head with an artificial ball, while preserving the rest of the hip joint. 
  3. Total hip replacement: For severely displaced fractures or fractures in people with pre-existing arthritis, total hip replacement surgery may be recommended. This surgery replaces both the femoral head and the acetabular socket (cup) of the hip joint with artificial components. 

After surgery, a comprehensive rehabilitation program is essential. In some cases, occupational therapy may be necessary to help individuals perform daily activities such as dressing, bathing, and using stairs safely. 

Additional Considerations: 

  1. Pain Management: Medicines will be provided to control pain after surgery and during recovery. 
  2. Prevention of blood clots: Medications or compression stockings can be used to reduce the risk of blood clots that may develop after surgery, especially for individuals who are on prolonged bed rest. 
  3. Nutritional Support: Ensuring adequate protein intake is critical for bone healing and muscle recovery. 

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