Hip Fractures

The hip joint is the largest weight-bearing joint in the body, and although it is strong and stable, it is not indestructible. The hip is a ball and socket joint made of the head of the thigh bone (femur), and the pelvis.

About Hip fractures

A hip fracture is a serious injury that can be life-threatening. Hip fractures are a medical emergency. In the U.S. more than 300,000 people age 65 and older suffer a hip fracture each year. Most occur in older women whose bones have become brittle due to osteoporosis. The negative consequences of a hip fracture include a poor quality of life, disability, depression, cardiovascular disease.

80% of hip fractures are experienced by 80-year-old women. Patients with a hip fracture are typically frail and often have multiple other illnesses including 40% who show cognitive impairment. Their care is complicated.

A majority of hip fractures occur in the top quarter or the neck of the femur, the lower leg bone that is the head that fits in the socket of the pelvis called the acetabulum. Other types of hip fracture which are less common occur in the acetabulum and in the pelvis and are not discussed here.

What causes a hip fracture?

95% of hip fracture are caused by falling, usually sideways that occur around the house or in the community. In women with osteoporosis (brittle bone disease), even a minor fall can cause a hip fracture. Sometimes, osteoporosis can cause a bone to break spontaneously causing a fall.

What are the hip fracture risk factors?

The risk of hip fracture includes:

• age- People over the age of 65 commonly experience a broken hip.
• osteoporosis – low bone density, affects both men and women, but women with osteoporosis are more likely to experience hip fractures from weakened bones.
• reduced activity or sedentary lifestyle
• multiple medications, including medications related to bone loss
• poor cognitive function (dementia)
• poor vision and balance problems
• being underweight
• smoking and excessive alcohol consumption
• Women diagnosed with type 2 diabetes after age 40 have an 82% increase in hip fracture risk compared to those without type 2 diabetes.

What are the symptoms of a hip fracture?

• immediate severe pain in the hip, groin and upper thigh
• inability to put weight on the leg, stand or move the leg or knee
• unable to walk or get up from a fall
• bruising and swelling around the hip joint
• the leg on the injured side is shorter than the other side
• an outward turning of the leg on the injured side

How is a hip fracture diagnosed?

Your OANC orthopedic surgeon will review your medical history and will conduct a complete physical examination including checking for other injuries. Plain x-rays can usually confirm a diagnosis, but if there is suspicion of an occult hip fracture an MRI or bone scan is the next step in diagnosis. An occult hip fracture is one that is sometime not obvious.

What are the treatment options for a hip fracture?

The majority of hip fractures are extremely painful and require emergency surgical repair or replacement followed by physical therapy and mobility to prevent complications such as blood clots. Other serious complications include UTI, pneumonia, and death. In some rare cases, where the patient without severe osteoporosis, nonoperative treatment will include pain management and early weight bearing.

Surgery to repair the fracture should occur within 48 hours of the injury.  The goal is to preserve the head of the femur and joint function. When the fracture is nondisplaced (not out of position) the bones will be joined together with screws and pins (internal fixation). When the fracture is displaced and unstable the options include total hip replacement and partial hip replacement based on the patient’s age and general health.

Elderly patients are cautioned to prevent falls by exercise, get enough Vitamin D, having an eye exam, checking the side effects of medications that can cause dizziness, and using a cane for stability.

When you have a loved one with a hip fracture contact Orthopedic Associate of Northern California in Chico, CA. We have been serving the northern state since 1995. Our board-certified orthopedic surgeons are here to serve you.