Medicine and Health
What is a hip fracture?
A hip fracture is a break in the thighbone (femur)of your hip joint.
Joints are areas where two or more bones meet. Your hip joint is a "ball and socket" joint, where your thigh bone meets your pelvic bone. The ball part of your hip joint is the head of the thighbone. The socket is a cup-like structure in your pelvic bone. This is called the acetabulum. Hip fracture is a serious injury and needs immediate medical attention.
Most hip fractures happen to people older than age 65. The incidence of hip fractures increases with age. Caucasians and Asians are more likely to be a ected than others. This is primarily because of a higher rate of osteoporosis. Osteoporosis (loss of bone tissue) is a disease that weakens bones.
Women are more prone to osteoporosis than men. And hip fracture is more common amon women. Aabout 2 million Americans have fractures each year becauseof osteoporosis.
Either a single break or multiple breaks can happen in a bone. A hip fracture is classi ed by the speci c area of the break and the type of break or breaks in your bone.
The most common types of hip fractures are:
- Femoral neck fracture. A femoral neck fracture happens1 to 2 inches from your hip join This type of fracture is common among older adults and can be related to osteoporosis. This type of fracture may cause a complication because the break usually cuts o the blood supply to the head of the thighbone, which forms the hip joint.
This type of fracture does not usually interrupt the blood supply to your bone and may be easier to repair.
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- Most hip fractures fall into these two categories in relatively equal numbers. Another type of fracture, called a stress fracture of the hip, may be harder to diagnose. This is a hairline crac in the thighbone that may not involve your whole bone. Overuse and repetitive motion can cause a stress fracture. The symptoms of this injury may mimic those of tendonitis or muscle strain.
What causes a hip fracture?
A fall is the most common reason for a hip fracture among the elderly. A few people may ha a hip fracture happen spontaneously. If you are younger, a hip fracture is generally the resul of a car accident, a fall from a great height, or severe trauma.
Hip fracture is more common in older people. This is because bones become thinner and weaker from calcium loss as a person ages. This is generally due to osteoporosis.
Bones a ected by osteoporosis are more likely to break if you fall. Most hip fractures that older people get happen as a resultof falling while walking on a level surface, often at home
Ifyou are a woman, you lose 30% to 50% of your bone densityas you age. The loss of bone speeds up dramatically after menopause because you make less estrogen. Estrogen contributes to maintaining bone density and strength.
Who is at risk for hip fracture?
You are at risk for a hip fracture if you have osteoporosis. Older age also puts you at more risk. Other things that may raise your risk include:
- Excessive alcohol consumption
- Lack of physical activity Low body weight
- Poor nutrition, including a diet low in calcium and vitamin D
- Gender
- Tall stature
- Vision problems
- Thinking problems such as dementia
- Physical problems
- Medicines that cause bone loss
- Cigarette smoking
- Living in an assisted-care facility
- Increased risk for falls ,related to conditions such as weakness, disability, or unsteady
There may be other risks, depending on your specificc health condition. Discuss any concerns with your healthcare provider.
What are the symptoms of a hip fracture?
The following are the most common symptoms of a hip fracture:
- Hip pain or pain that you can feel in your knee
- Low back pain
- Inability to stand or walk
- Bruising and swelling
- Foot turned out at an odd angle, making your leg look shorter
The symptoms of hip fracture may seem like other medical conditions. Always see your healthcare provider for a diagnosis.
How is a hip fracture diagnosed?
In addition to a complete medical history and physical exam, diagnostic procedures for hip fracture may include the following:
- X-ray. Invisible electromagnetic energy beams produce images of internal tissues, bones and organs onto lm.
- MRI. A combination of large magnets, radio waves, and a computer make detailed image of organs and structures within your body.
- CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.
How is a hip fracture treated?
A fracture of your hip is generally treated with surgery. Your surgeon may use metal devices to strengthen and stabilize your joint. In some cases, they may do a partial or total hip replacement. The type of surgical repair will depend on the type of hip fracture. Your surgeo will determine the best procedure for you, based on your situation. The goal of treatment is provide relief from pain and enable you to resume your normal activity level. Hip surgery usually requires an in-hospital stay. While in the hospital, you start doing physical therapy exercises to regain strength and range of motion in your hip. Physical therapy will continue a home or on admission to a rehabilitation facility.
What are possible complications of hip fracture
Serious complications can result from a hip fracture. Blood clots can happen in the veins, usually in your legs. If a clot breaks o , it can travel to a blood vessel in your lung. This blockage ,called a pulm onaryembolism, can be fatal.
Other complications can include:
- Pneumonia
- Muscle atrophy (wasting of muscle tissue)
- Postoperative infection
- Nonunion or improper union of your bon
- Mental deterioration after surgery in older patients
- Bedsores from lying in the same position with minimal movement
With some fractures, blood can't circulate properly to the head of the thigh bone. This result in a loss of blood supply to this area. This is called femoral avascular necrosis. This complication may happen, depending on the type of fracture and the anatomy of your blood supply to the head of the thigh bone. This is more common with femoral neck fractures.
Most people spend 1 to 2 weeks in the hospital after a hip fracture. The recovery period may be lengthy and may include admission to a rehabilitation facility. If you were previously able live independently, you will generally need help from home caregivers or family, or need the services of a long-term care facility. Hip fractures can result in a loss of independence, reduced qualityof life, and depression. This is especially true for older people. What can I do to preventa hip fracture?
Preventive measures include taking enough calcium every day.
If you are a woman in menopause, you should consider having a bone density test. This measures your bone mineral content and the thick nessof your bone. This measurement ca indicate decreased bone mass. This is a condition in which your bones are more brittle and prone to break or fracture easily. A bone density test is used primarily to diagnose osteoporosis and to determine fracture risk.
Women make less estrogen when menopause starts. Most people do not know they have osteoporosis until they have a fracture.
Another way to help prevent hip fracture is to do regular weight-bearing exercise, such as walking, jogging ,or hiking. Exercise programs such as tai chi help promote strength and
balance.
Other preventive measures may include:
- Taking medicines as prescribed by your healthcare provider to prevent bone loss
- Asking your healthcare provider to review your medicines to see if any might make you dizzy or sleepy
- Eating a diet rich in vitamin D and calcium, including milk, cottage cheese, yogurt, sardine and broccoli
- Stopping smoking
- Not drinking too much alcohol
- Keeping objects, such as electrical cords, o the stairs and oorsto prevent falls
- Using slip-resistant rugs next to the bathtub, and installing grab bars in the tub
- Positioning night lights from the bedroom to the bathroom
- Using rug pads or nonskid back ingto keep rugs in place Not using unsteady furniture or step ladders to stand on
- Visiting an ophthalmologist every year to have vision checked and vision loss treated
Key points about hip fracture
- Most hip fractures happen to people of older age.
- A fall is the most common reason for a hip fracture among elderly adults.
- Hip fracture is more common among women.
- Osteoporosis and advancing age are the major risk factors.
- A fracture of the hip is generally treated with surgery.
- Serious complications can result from a hip fracture.
- Women at menopause should consider having a bone density test.
- Regular weight-bearing exercise helps to prevent a hip fracture.