Hip Fracture

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About

In the US the number of hip fracture injuries has reached approximately 300,000 a year. As a serious injury that commonly affects women, a hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. This type of fracture is treated by undergoing a surgical procedure primarily based on the bones and soft tissues affected or on the level of the hip fracture.

Specialists who treat hip fracture:

  • Orthopedic Surgeon – physicians who manage special problems of the musculoskeletal system. Orthopedic surgeons diagnosis your injury or disorder, provide treatment with medication, exercise, surgery or other treatment plans, encourage rehabilitation by recommending exercises or physical therapy to restore movement, strength and function. Orthopedic surgeons prepare patients for surgery as advanced stages of arthritis require surgical correction.
  • Physical Medicine & Rehabilitation – is a medical specialty concerned with diagnosis, evaluation, and management of persons of all ages with physical and/or cognitive impairment and disability.
  • Pain Medicine – the field of medicine that is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain.
  • Physical Therapist - health care professionals who can help patients reduce pain and improve or restore mobility through developing fitness and wellness programs for healthier and more active lifestyles.

Types

Common types of hip fracture:

  • Intracapsular fracture - these fractures occur at the level of the neck and the head of the femur, and are generally within the capsule. The capsule is the soft-tissue envelope that contains the lubricating and nourishing fluid of the hip joint itself.
  • Intertrochanteric fracture - this fracture occurs between the neck of the femur and a lower bony prominence called the lesser trochanter. The lesser trochanter is an attachment point for one of the major muscles of the hip. Intertrochanteric fractures generally cross in the area between the lesser trochanter and the greater trochanter. The greater trochanter is the bump you can feel under the skin on the outside of the hip. It acts as another muscle attachment point.
  • Subtrochanteric fracture - this fracture occurs below the lesser trochanter, in a region that is between the lesser trochanter and an area approximately 2 1/2 inches below.

Less common types of hip fracture:

  • Stress fracture - less common than other types of hip fractures, a stress fracture is a hairline crack in the femur that may not involve the entire bone. Stress fractures are caused by overuse and repetitive motion, and the symptoms are often similar to those of tendonitis or muscle strain.

Symptoms

Hip fracture symptoms may include:

  • Inability to move immediately after a fall.
  • Severe pain in your hip or groin.
  • Inability to put weight on your leg on the side of your injured hip.
  • Stiffness, bruising and swelling in and around your hip area.
  • Shorter leg on the side of your injured hip.
  • Turning outward of your leg on the side of your injured hip.

Risk Factors & Prevention

Risk factors for hip fractures include:

  • Age. The rate of hip fractures increases substantially with age, which is why older adults are most prone to suffering from a hip fracture. As you age, your bone density and muscle mass both decrease. Older age may also bring vision and balance problems, along with slower reaction time to avoid falling when you feel unsteady. If you're inactive, your muscles tend to weaken even more as you age. All of these factors combined can increase your risk of a hip fracture.
  • Your sex. Women lose bone density at a faster rate than men do. The drop in estrogen levels that occurs with menopause accelerates bone loss, increasing the risk of hip fractures. However, men also can develop dangerously low levels of bone density.
  • Chronic medical conditions. Osteoporosis is the most powerful risk factor for hip fracture, but other medical conditions may lead to fragile bones. These include endocrine disorders, such as an overactive thyroid, and intestinal disorders, which may reduce your absorption of vitamin D and calcium.
  • Certain medications. Cortisone medications, such as prednisone, can weaken bone if you take them long term. In some cases, certain drugs or the combination of medications can make you dizzy and more prone to falling.
  • Nutritional problems. Lack of calcium and vitamin D in your diet when you're young lowers your peak bone mass and increases your risk of fracture later in life. Serious eating disorders, such as anorexia nervosa and bulimia, can damage your skeleton by depriving your body of essential nutrients needed for bone building.
  • Physical inactivity. Weight-bearing exercises, such as walking, help strengthen bones and muscles, making falls and fractures less likely. If you don't regularly participate in weight-bearing exercise, you may have lower bone density and weaker bones.
  • Tobacco and alcohol use. Smoking and drinking alcohol can interfere with the normal processes of bone building and remodeling, resulting in bone loss.

Reduce the onset of hip fracture by:

  • Exercising to strengthen bones and improve balance. Weight-bearing exercises, such as walking, encourage your body to increase bone density. Exercise also increases your overall strength, making you less likely to fall. Try to exercise for 30 minutes a day on most days of the week. Balance training is also key to reducing your risk of falls, since balance tends to deteriorate with age.
  • Not drinking excessively or smoking. Preserve your bone density by avoiding the excessive use of alcohol and by not smoking. Drinking too much alcohol also can impair your balance and make you more likely to fall.
  • Assessing your home for fall hazards. Remove throw rugs, keep electrical cords against the wall, and clear excess furniture and anything else that could trip you. Make sure every room and passageway is well lit.
  • Getting your eyes checked. Go to your eye doctor for an exam every other year, or more often if you have diabetes or an eye disease.
  • Watching your medications. Feeling weak and dizzy, which are possible side effects of many medications, can increase your risk of falling. Talk to your doctor about side effects caused by your medications.

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