Hip fractures occur when the fracture affects the upper end of the thigh bone - the femur. Elderly people and patients with osteoporosis have an increased risk of hip fractures. Most fractures are treated surgically and then with physical therapy, with the aim of making the patient independent in daily life activities.
What is a Hip fracture?
Hip fractures occur as a result of falls and traffic accidents, and are much more common in older people because bones weaken and become more fragile with age.
Most hip fractures are accompanied by severe pain and require surgical treatment as soon as possible. Physical therapy after surgery can significantly improve the outcome of treatment.
How common is Hip fracture?
Hip fractures are common. Risk factors are:
- age - over 65 make up the majority of cases
- gender - 75% of patients with a hip fracture are women
- lifestyle - people who live a sedentary lifestyle have a higher risk of hip fractures; excessive alcohol consumption also weakens bones
- osteoporosis - this disease makes bones weaker and more fragile, which increases the risk of fractures; women have osteoporosis four times more often than men
- overall condition of the organism - people who do not have enough vitamin D, calcium and other minerals have a higher risk of fractures. Some diseases (e.g. Dementia and Parkinson's disease) increase the risk of falls and, consequently, fractures.
What part of the bone can be broken?
The hip joint consists of a "cap" (acetabulum) formed by the bones of the pelvis and the upper end (head) of the thigh bone (femur), which looks like a "ball". Ligaments, tendons and muscles support the joint and enable movement. Fractures can occur in several regions, but the most common fractures are:
- neck of femur - the neck extends from the head to the pertrochanteric region
- pertrochanteric regions - this is the part of the upper leg tocated between the neck and the long straight part of the bone (diaphysis)
What are the symptoms of a Hip fracture?
Symptoms appear at the same time as the fall, but worsen over time. Signs of a hip fracture include:
- pain in the hip and groin area, thighs and sometimes knees. The pains are strong and sharp, sometimes less intense
- limited mobility - most patients cannot stand or walk
- changes in appearance - the foot is turned "outwards", the injured leg is shorter and a blood bruise (hematoma) is visible.
What is the cause of Hip fracture?
Hip fracture most often occur as a result of a fall or traffic accident. Athletes, especially long-distance runners, can suffer a "stress fracture" in the hip area. Elderly people and patients with osteoporosis can sustain a hip fracture during innocuous activities, such as turning on one leg, standing up and sitting down, or minor falls.
How is a Hip fracture diagnosed?
The examination begins with taking of anamnesis and status, and then X-ray imaging and, if necessary, additional MSCT or MRI.
How are Hip fractures treated?
Most patients with a hip fracture require surgery within 24 or 48 hours. Some patients are unable to tolerate surgery and are treated conservatively.
Types of surgical treatment
- Osteosynthesis - fracture repair with the help of metal implants that allow the bone to heal
- Hip replacement with a prosthesis – partial and total hip replacement come into consideration
After the surgical treatment, intensive physical therapy is carried out with the aim of restoring the patient's strength, mobility and, finally, independence.
What to expect after a Hip fracture?
A hip fracture can change your previous lifestyle. Many older people fail to regain their previous mobility or independence after a hip fracture. Some patients need a walking aid, some need round-the-clock health care.
The outcome depends on several factors:
- age - older age comes with more complications and longer recovery
- early physical therapy - patients who quickly start moving after surgery have a significantly better prognosis
- type of fracture - some fractures are without displacement and heal quickly, and some are more severe and heal more slowly.