HIP FRACTURE

 Basic information

description

A hip fracture is a complete or partial break (fracture) in the femur. The femur is the major bone in the hip joint. Breaks from common injuries affect both sexes and all ages. Spontaneous (occurs without an injury) breaks, and breaks from minor injuries, affect mostly older people. Nine out of 10 hip fractures occur in persons over 65, and 3 out of 4 occur in women.

FREQUENT SIGNS & SYMPTOMS

• Severe pain when trying to walk.
• Pain may occur in the groin or thigh.
• Swelling, tenderness, and bruising in the hip area.
• Deformed hip appearance.

causes

Hip fractures are usually caused by injuries (trauma) such as falls, other types of accidents, and sports injuries. Weakened bones are more at risk of a fracture.

risk increases with

• Female, over age 65, and white.
• Osteoporosis, especially in women after menopause.
• Decreased bone mineral density; fragile bones.
• Falls. Risk of falls increases with muscle weakness, problems with walking or balance, use of certain drugs, disorders such as Parkinson's and stroke, poor eyesight, foot problems, arthritis, previous falls, and home risks.
• Self-reported poor health.
• Family history of hip fracture.
• Sedentary (lack of physical activity) lifestyle.
• Previous fractures of any kind.
• Previous hyperthyroidism.
• Motor vehicle accidents and physical activities such as contact sports for younger hip fracture patients.

PREVENTIVE MEASURES

• Protect against falls, especially in the home.
• Drug therapies to improve bone density.
• Daily exercise program to improve bone strength and to maintain muscle strength and balance.
• Sufficient intake of calcium and vitamin D.

expected outcomes

Outcome depends on the age and health of the patient and the location of the fracture. In older persons, there is often a loss of ability to function as they did before the fracture. The function loss may be mild to severe.

possible complications

• Surgical-wound infection, incomplete healing, and other surgery complications.
• Long-term immobility can lead to blood clots, pulmonary embolism, pneumonia, and weak muscles.
• Loss of mobility (may require wheelchair use), loss of independence, reduced quality of life, and depression.

 diagnosis & treatment

general measures

• Self-care is not appropriate. Hospital care with surgery is the main treatment. Nonsurgical measures, such as traction, may be used if surgery is too risky for a patient.
• A femoral neck fracture is treated either by hip pinning (using screws) or hip hemiarthroplasty (hip replacement). The choice depends on patient's age and severity of fracture.
• An intertrochanteric hip fracture is repaired with a metal plate and screws or a rod inserted down the center of the bone.
• After surgery, time is spent in a rehab center for therapy to help regain mobility and functions of daily living.
• Ongoing physical therapy may be needed to continue to rehabilitate the muscles, bones, and joints.

medications

• Pain relievers as needed may be prescribed.
• Antibiotics for infection and blood thinners to prevent blood clots may be prescribed after surgery.
• Stool softeners to prevent constipation.
• Drugs to increase bone mass and to prevent bone loss may be prescribed.

activity

• After surgery, move the unaffected leg often to decrease the risk of deep-vein blood clots. Most patients are urged to get up and move about as soon as possible.
• A physical therapist will be needed for rehabilitation, which can take several months. A walker or crutches will be used at first. Swimming and riding an exercise bike are good forms of therapy.
• Resume your normal activities to the extent possible as healing progresses.

diet

A diet higher in calcium and vitamin D may be advised.

 notify our office if

• You or a family member has symptoms of a hip fracture. Call immediately if you have numbness or loss of feeling below the fracture site. This is an emergency!
• Any new symptoms develop after surgery.

Special Notes: