Categories: Orthopaedics

Hip Fractures: Causes, Symptoms, Treatment

Each year, a huge population, especially at the age of 65 and above, sustains a fracture in the hip. Hip fractures are very painful and require prompt medical assistance. The faster we can treat the condition, the sooner the patient will get out of bed. Otherwise, there will be chances of blood clots, sores and pneumonia. In patients on the wrong side of age, long bed rest can result in immobility. After this, recovery and getting a normal life becomes very difficult.

What is a hip fracture?

A hip fracture is nothing but the breaking of the upper portion of the femur or the thigh bone. Elderly ones are the most likely to suffer as their bones are already weak due to osteoporosis.

The hip is nothing but a ball-and-socket joint. A hip fracture can injure any of the following four areas in the upper femur:

  • Femoral Head-This is the ball of the femur which positions itself in the socket.
  • Femoral Neck-The portion of the femur below the femoral head.
  • Intertrochanteric Area-This is the portion below the femoral neck and the shaft or the long part of the femur. It has two bony areas, the lesser trochanter and the greater trochanter.
  • Subtrochanteric Area-The upper portion of the femoral shaft, below the two trochanters.

Around 90% of the fractures in the hip fall in the categories of intertrochanteric hip fracture or femoral neck fracture. The stress fracture also falls in the hip fracture types but is relatively harder to diagnose. A hairline crack in the femoral region may happen. It may not involve the entire bone.

Causes of Hip Fracture

  • Many elderly people suffer from a hip fracture because of a fall. They might have a weak or osteoporotic bone. Even a small twist or tripping may result in something terrible. In some of them, the bones might be so weak that the break can occur as the person is standing or walking. A hip fracture in the elderly is the most common case a doctor gets.
  • Repeated impact results in stress fractures too, often seen in athletes. The subtrochanteric region is the most affected part here.
  • Fractures in the femoral head often result from a high-velocity impact like an accident or a fall. Usually, the hip dislocates as a result of the condition.
  • Females are often prone to hip fractures because of their anatomy and lifestyle conditions. Often, family history also is responsible for having fractures. Being too thin or tall can have greater chances of a fracture in the hip.
  • Deficiency of vitamin D or calcium, which are essential for strong bones, not having an active lifestyle, lack of exercises all increase the chances of having a hip fracture.
  • Smoking is something that contributes to almost every adverse physical condition including a propensity for hip fracture.
  • Other than these, taking medicines like steroids or having conditions like arthritis can also result in a fracture in the hips.

Symptoms of Hip Fracture

To begin with, hip fractures are not short of pain. In fact, they are excruciatingly painful. There is pain in the groin and the upper area of the thighs. When you suffer a fracture in the hip, you will not be able to stand, move or bear weight. There will be a complete loss of mobility in the ankles, the toes, the knees and the legs. Hip fracture symptoms should be addressed as fast as you can.

Surgical Treatment

Most of the fractures need surgical treatment within a day or two of incurring the injury. A hip fracture surgery works well, but it takes a long time to heal.

Surgical treatment is needed to relieve the person of acute pain. It also helps the patient to come out of bed. The sooner the surgery is done, the lesser are the risks of getting complications. Treatment for hip fracture is primarily dependent upon three things. The type, the location of the fracture and the age and condition of the person are what determines the step to be taken.

Following are the two main types of surgery:

  • Hip repair surgery is also known as fixing internally or hip pinning. Here the doctor uses screws, plates or rods made of metal to hold together the bones, as they are healing. The doctor goes for this kind of surgery if they have been able to line up the bones correctly.
  • Hip replacement surgery is about replacing the joint with artificial parts, either partially or wholly. When it is a partial replacement of the hip, the doctor replaces the upper part of the broken thigh bone. When it is a total replacement, both the socket of the hip and the upper portion of the thigh bone gets replaced. Complete replacement of the hip is done when the doctors are not able to line up the fractured bones correctly.

After the surgery is done, the doctors advise starting moving as soon as possible. This is because there are chances of contracting bedsores, pneumonia and blood clots otherwise. When the surgery is done, you might not be immediately able to start cooking or getting dressed on your own. You might have to adopt rehabilitative procedures thereafter.

Rehabilitation is about occupational therapy and physical therapy. These teach you:

  • Safer ways of staying active.
  • Exercises to regain strength and be mobile.
  • Newer ways of doing simple activities.

 Non-surgical treatments

If there is a fracture, and you are looking for hip fracture treatment without surgery, there are specific non-invasive methods. If the bone fragments are still in their place, you can go for these methods:

Activity Modification – After a hip fracture, the doctor may suggest not putting any weight on the affected area for at least six weeks. This gives some time to the bone to heal. You will have a walker, a cane or crutches to move around.

Electronic and Ultrasonic Bone Stimulation – The bone stimulation technique helps in the quick healing of the bone. Here, a low-electric current or a low-intensity pulsed sound wave is used.

 Physical therapies – These are nothing but a range of exercises to maintain the motion and the strength in the muscles and the joints around the injured area. Examples of these activities are leg lifts and stretching the hamstrings.

Whether you opt for an operative procedure or a non-surgical one, always resort to expert guidance.

Dr. Kinner Avashia | Consultant – Orthopaedics | Narayana Multispeciality Hospital, Ahmedabad

Narayana Health

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