The hip joint is a ball and socket joint where the femur head (ball) links the pelvic bone (socket). Hip fracture is break of the femur bone. About 90% of hip fractures occur in people above the age of 60. The risk for fracture multiples with increasing age due to osteoporosis. Osteoporosis is a natural degenerative condition that causes loss of bone tissue. There are two types of hip fractures:
Femur Neck Fracture – this occurs within the hip joint through the narrowest part of bone.
Intertrochanteric hip fracture – this occurs outside the hip joint through the broadest part of bone.
Hip fractures cause significant pain and loss of mobility necessitating admission to hospital. Reduced mobility can lead to pneumonia, urinary tract complications, constipation, bed sores clotting of blood in the leg veins, muscle atrophy from disuse and mental deterioration. Surgical fixation of the fracture offers the best chance of early return to limited mobility.
Femur Neck Fracture – Replacement of the ball with or without use of cement (open surgery)
Intertrochanteric Hip Fracture – Internal fixation by plate or nail (limited open surgery)
45 to 60 minutes
General anesthesia or regional (spinal) blockade.
04 to 05 days
Under cover of appropriate pain medication the patient is mobilized out of bed the day after surgery. Walker aided full weight bearing and ambulation around the bed is encouraged. Nutritional support is vital and along with exercises for general well-being under guidance of trained physiotherapists. It is strongly recommended to continue medication for existing ailments (hypertension, hypothyroid, asthma) under guidance of the physician.
Specific treatment depends on age, overall physical and mental health. On one hand prolonged bed rest is associated with serious complications and surgical fixation is also not risk-free. Despite surgery there is significant loss of independence, reduced quality of life and depression.
A regional report by the International Osteoporosis Foundation (IOF) has found Indians experience 4.4 lakh hip fractures every year. Combined with a rising elderly population, this is a cause of concern for medical personnel and patients alike.
The IOF explains that hip fractures are invariably associated with symptoms such as chronic pain, reduced mobility, disability, and an increasing degree of dependence.” In fact, more than half of those who survive a hip fracture never regain their previous level of function, and the mortality rate also increases among those who have experienced this break: worldwide, hip fractures contribute to both morbidity and mortality in the elderly.
While efforts are being made to increase post-fracture outcomes via integrated care pathways which have found success in Sweden and the UK, how can elderly individuals lower or altogether eliminate their risk of hip fracture?
Any discussion of hip fractures in the elderly must include a discussion of osteoporosis, a disease that causes bones to become fragile and brittle, increasing an individual’s risk of fracture.
To prevent the development of the disease, doctors will often prescribe a combination of pharmaceutical intervention and supplements. Drugs used to treat osteoporosis include Alendronate and Risodronate, given to increase bone calcium content in the patient’s body. Supplements will often include calcium, Vitamin D, Calcitonin to increase bone calcium absorption, and Teraparatide, a hormone given via injection to increase bone formation.
Of course, the best method of treatment is the prevention of osteoporosis. Medical experts recommend following a healthy diet consisting of milk and milk products and walking daily for 40 minutes.
Falls are the highest cause of hip fractures in the elderly and as such, preventing a fall can prevent a hip break. We recommend the following:
Hip fractures are serious concerns for the elderly. With proper attention paid to preventing and treating osteoporosis and avoiding falls, seniors can lower their risk, decreasing their risk of lowered independence and maintaining their levels of overall health.
“This article has been contributed to our website by Sally Perkins”.