Hip fracture

Description

A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture increases with age.

The risk increases because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to fall — one of the most common causes of hip fracture.

A hip fracture almost always requires surgical repair or replacement, followed by physical therapy. Take the measures necessary to maintain bone density and prevent falls can help prevent a hip fracture.

Symptoms

The signs and symptoms of a hip fracture include:

  • Inability to get up from a fall or foot
  • Severe pain in the hip or groin
  • Inability to put weight on the leg on the side of the lesion in the hip
  • The bruising and swelling in and around the area of the hip
  • Shorter leg on the side of the lesion in the hip
  • Clumsiness of the leg on the side of the lesion in the hip

Causes

A serious impact, such as a car accident, can cause hip fractures in people of all ages. In older adults, a hip fracture is most often the result of a fall from a standing height. In people with weak bones, a hip fracture can occur simply by standing on the leg and twisting.

Risk factors

There are many things that can increase the risk of hip fractures.

Your age and gender

Bone density and muscle mass tend to decrease with age. Older people may also have problems with vision and balance, which can increase the risk of falls.

Hip fractures occur in women, about three times more often than in men. Women lose bone density faster than men, in part due to the decrease in the levels of estrogen that occurs with menopause accelerates bone loss. However, men can also develop dangerously low levels of bone density.

Medical conditions

The hip fracture risk may be greater if you have:

  • Osteoporosis. This disease weakens bones and makes them more likely to break.
  • Problems of the thyroid. An overactive thyroid can lead to brittle bones.
  • Intestinal disorders. Conditions that reduce the absorption of vitamin D and calcium can also cause weakening of the bones.
  • Problems with balance. Parkinson's disease, stroke, and peripheral neuropathy can increase the risk of falls. Having low blood sugar or low blood pressure can also contribute to the risk of falls.

Certain medications

Cortisone medications, such as prednisone, can weaken the bones if taken long-term. Certain medicines, or certain combinations of drugs that can cause dizziness, which can increase the risk of falls. The most common medications associated with falls include sleep medications, antipsychotics and sedatives.

Nutritional problems

The lack of calcium and vitamin D in the diet of young people decreases the peak bone mass and increases the risk of fracture later in life. It is also important to get enough calcium and vitamin D in older people to try to maintain bone density. The deficit of weight also increases the risk of bone loss.

Lifestyle options

The lack of weight-bearing exercises, such as walking, may result in a weakening of the bones and muscles, causing falls and fractures more likely.

Tobacco and alcohol can interfere with the normal processes of the bones of construction and maintenance, resulting in the loss of bone.

Complications

A hip fracture can reduce the independence and, at times, life-shortening. About half of the people who have a hip fracture are not able to regain the ability to live independently.

When hip fractures to avoid the movement for a long time, complications can include:

  • Blood clots in the legs or lungs
  • Bedsores
  • Pneumonia
  • In addition to the loss of muscle mass, increasing the risk of falls and injuries
  • Death

Prevention

The healthy lifestyle in early adulthood building a higher peak bone mass and reduce the risk of osteoporosis in later years. The same steps taken to any age may reduce the risk of falls and improve health in general.

To prevent falls and to maintain healthy bones:

  • Get enough calcium and vitamin D. In general, men and women 50 years of age and older should consume 1,200 milligrams of calcium per day, and 600 international units of vitamin D a day.
  • Exercise to strengthen your bones and improve your balance. Weight-bearing exercises, such as walking, help maintain peak bone density. The exercise also increases strength in general, decreasing the risk of falls. Balance training is also important for reducing the risk of falls as the balance tends to deteriorate with age.
  • Avoid smoking or drinking in excess. Tobacco and alcohol use may reduce bone density. Drinking too much alcohol can also impair balance and increase the risk of falls.
  • Evaluate the home for hazards. Remove the carpet, keep electrical cords against the wall, and clear excess furniture and anything that can trip people. Make sure that all the rooms and hallways are well lit.
  • Check their eyes. Have an eye exam each year, or more often if you have diabetes or a disease of the eyes.
  • The use of a cane, a cane or a walker. If you do not feel firm to the walk, ask a doctor or occupational therapist if these aids could help.

Hip fracture

Diagnosis

A health care provider can often diagnose a hip fracture based on your symptoms and the abnormal position of your hip and leg. The X-ray usually will confirm the fracture and show where the fracture is.

If the x-ray doesn't show a fracture but you still have hip pain, your healthcare provider may order an mri or bone scan to look for a fracture.

The majority of hip fractures occur in one of two places in the long bone that extends from the pelvis to the knee (femur):

  • The femoral neck. This area is situated in the upper part of the femur, just below the ball (femoral head) of the ball-and-socket joint.
  • The region intertrochanteric. This region is a little below the hip joint, in the part of the upper part of the femur, which is projected towards the exterior.

Treatment

The treatment for hip fracture usually involves a combination of symbol of the surgical repair, rehabilitation, and medication to control the pain and to prevent blood clots and infection.

Surgery

The type of surgery generally depends on where and the severity of the fracture, since the broken bones are not properly aligned (internally displaced persons), and your age and underlying health conditions. The options include:

  • Internal repair using screws. Metal screw is inserted into the bone to hold it together while the fracture heals. Sometimes the screws are connected to a metal plate that extends to the thigh bone (femur).
  • The Total hip arthroplasty. The upper part of the femur and the socket in the pelvic bone are replaced with artificial parts (prostheses). Increasingly, studies show total hip replacement to be more cost-effective and is associated with better long-term outcomes in otherwise healthy adults who live independently.
  • Partial hip replacement. In some situations, the socket of the hip does not need to be replaced. Partial hip replacement may be recommended for adults who have other health conditions or who can no longer live independently.

Surgeons may recommend complete or partial hip replacement if the blood supply to the ball of the hip joint was damaged during the fracture. That type of injury, which occurs more often in older individuals with fractures of the femoral neck, it means that the bone is less likely to heal properly.

Rehabilitation

The physical therapy was initially focus on range-of-motion and strengthening exercises. Depending on the type of surgery and if there is help in the house, go to an extended care facility may be necessary.

In the extension of care and in the home, an occupational therapist will teach you the techniques for independence in daily life, such as using the toilet, bathing, dressing, and cooking. An occupational therapist will determine if a walker or a wheelchair may be needed to regain mobility and independence.

Preparing for your appointment

You may be referred to an orthopedic surgeon.

What to expect

Your health care provider might ask:

  • Have fallen recently, or had another type of injury to the hip?
  • How severe is your pain?
  • You can put weight on the leg that is on the side of his hip injury?
  • Have you had a bone density test?
  • Have you been diagnosed with any other medical condition? What medicines you are taking, including vitamins and supplements?
  • Make use of alcohol or tobacco?
  • Have you ever had surgery? Were there any problems?
  • Do any of your blood relatives, such as a parent or a sibling have a history of fractures of the bones, or osteoporosis?
  • Do you live independently?
Symptoms and treatment of Hip fracture