What Leads to Hip Fracture?

Hip fractures predominantly occur in the geriatric population when they experience a fall as a result of compromised bone integrity. Even a seemingly minor fall can lead to a hip fracture in older individuals. Osteoporosis significantly contributes to the occurrence of hip fractures following a simple fall. A person with brittle bones may stumble and fall within their own residence, resulting in a hip fracture.

In certain instances, there exists the potential for the hip to fracture spontaneously in individuals with fragile bones. The physiological irregularities in blood pressure, visual acuity impairment, and diminished reflex and muscle vigor in the elderly create a conducive environment for falls. Prolonged utilization of osteoporosis medications may also induce bone stiffening, thereby facilitating the occurrence of fractures. In the case of younger individuals, such fractures typically manifest as a consequence of severe accidents.

What Are the Symptoms of a Hip Fracture?

• Severe pain manifests in the groin or upper thigh area.
• Swelling and tenderness are evident.
• Significant bruising or redness is observed on the hip region.
• A person with a hip fracture experiences discomfort when rotating their hip joint.
• The individual is unable to sit, lie down, walk, or move about with ease on their hips.

How is a Hip Fracture Diagnosed?

Displaced hip fractures are readily diagnosable. The patient experiences an inability to ambulate accompanied by intense pain in the hip region exacerbated by movement. The affected leg appears shortened and rotated outward. While x-rays are typically sufficient for diagnosis, certain non-displaced fractures may require more advanced diagnostic modalities such as computed tomography and magnetic resonance imaging.

In elderly individuals presenting with hip pain and immobility following a fall, suspicion of hip fracture should prompt immediate transportation to the hospital via ambulance. Fracture evaluation is warranted in cases of unexplained hip or groin discomfort in the elderly.

What are the Types of Hip Fracture?

There are three categories of hip fractures, namely femur fracture, trochanteric fracture, and subtrochanteric fracture. These classifications are based on the specific location of the fracture.

Fracture of the femur: A femur fracture is typically the result of trauma affecting any segment of the thigh bone, known as the femur, situated between the hip joint and the knee joint. The primary indicators of a femoral fracture include intense pain and noticeable swelling. This type of fracture is more prevalent among women aged over 60 compared to men. A definitive diagnosis is typically established through X-ray imaging.

Trochanteric fracture: Trochanteric fractures are more frequently observed in individuals aged over 70.

Subtrochanteric fracture: Subtrochanteric fractures usually occur due to significant traumas such as vehicular accidents, gunshot wounds, or falls. These fractures are characterized by their location in the upper part of the femur.

How Is The Treatment for Hip Fractures?

Hip fractures occurring in the elderly are of utmost importance and significance. If left untreated, such fractures can render the patient immobile, hindering their ability to carry out daily activities. Immobile due to the fracture, the patient is at risk of developing pressure ulcers on their back and may experience pulmonary complications.

Therefore, prompt initiation of treatment for hip fractures is crucial to enable the patient to resume a healthy and active lifestyle. The management of hip fractures should commence expeditiously to expedite the recovery process. For instance, if a hip fracture patient undergoes surgery within 24 hours, the fracture may go unnoticed by the patient. Conversely, delaying surgery beyond 72 hours significantly elevates the risks of mortality and morbidity.

The treatment approach varies based on the fracture type, patient's age, and overall health status. Non-surgical interventions may be favored for stable fractures, necessitating strict bed rest and close monitoring for any signs of displacement. Surgical interventions, on the other hand, involve the application of prostheses or osteosynthesis based on factors such as age, bone strength, and the nature of the femur fracture.

For younger individuals with hip fractures, procedures like nailing or screwing are implemented to promote fracture fusion. Conversely, elderly patients with a lower likelihood of bone union typically undergo total or partial prosthesis treatment. In cases of trochanteric and subtrochanteric fractures, compression hip nailing surgery is commonly preferred to facilitate bone union.

Post-Surgery Process

Patients should be provided with physiotherapist assistance to facilitate their mobilization post-discharge to their residences or rehabilitation facilities following surgery. It is imperative to elucidate the prescribed exercises to the patient. Emphasizing the significance of aiding the patient in standing up and engaging in daily activities post-surgery is equally crucial as the surgical intervention itself.

Rehabilitation

    - Following surgical or non-surgical interventions, rehabilitation plays a crucial role in restoring mobility and function.

    - Physical therapy sessions aim to strengthen muscles, improve range of motion, and enhance balance to prevent future falls.

Osteoporosis Management

    - Addressing underlying conditions like osteoporosis is essential to prevent recurrent hip fractures.

    - Medications, dietary changes, and lifestyle modifications can help improve bone density and reduce fracture risk.

Fall Prevention

    - Implementing fall prevention strategies at home and in healthcare settings is vital to reduce the likelihood of hip fractures.

    - Installing grab bars, removing tripping hazards, and ensuring adequate lighting can enhance safety for elderly individuals.