Overview
A hip fracture is a serious injury that involves a crack or break in the thighbone (femur) or the pelvis. It is often caused by falls, particularly in older individuals with weakened bones due to conditions like osteoporosis. Hip fractures can lead to life-threatening complications and typically require surgical repair or replacement, followed by physical therapy. Symptoms include severe pain in the hip or groin, inability to put weight on the affected leg, and visible bruising and swelling in the affected area. Prevention methods include maintaining bone density and reducing the risk of falls.
Understanding the disease
Symptoms
The symptoms of a hip fracture include severe pain in the hip or groin, inability to put weight on the leg on the side of the injured hip, bruising and swelling in and around the hip area, a shorter leg on the side of the injured hip, and outward turning of the leg on the side of the injured hip.
Risk Factors
Risk factors for developing hip fractures include age and sex, as bone density and muscle mass tend to decrease with age, and older people can have problems with vision and balance. Hip fractures occur in women about three times more often than in men. Medical conditions like excessive alcohol consumption, tobacco use, and osteoporosis can also increase the risk of hip fractures. Other factors such as taking certain medications, having a lack of calcium and vitamin D in the diet, being underweight, and engaging in a lack of regular weight-bearing exercise contribute to an increased risk. Falls are the most common cause of hip fractures, and poor balance and vision can contribute to falls in older adults.
Development
Hip fractures can develop due to a severe impact, such as a car crash, or as a result of a fall from a standing height, which is a common cause in older adults. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting. Stress fractures can also develop from normal use of a bone that's weakened by conditions such as osteoporosis. Stress fractures are caused by repetitive force, often from overuse, and can be more likely in individuals with risk factors like a history of osteoporosis or engaging in activities that involve high impact or repetitive motions.
Assessment and Diagnosis
Triage
You should see a doctor if you suspect a hip fracture as soon as possible. Symptoms of a hip fracture include severe pain in the hip or groin, inability to put weight on the leg on the side of the injured hip, inability to get up from a fall or walk, and severe pain that worsens with movement. Hip fractures require prompt medical attention as they can lead to life-threatening complications.
Diagnosis
A health care provider can diagnose a hip fracture based on symptoms and the abnormal position of the hip and leg. An X-ray is usually used to confirm the fracture and determine its location. If the X-ray does not show a fracture but hip pain is present, further imaging tests such as an MRI or bone scan might be ordered to check for a hairline fracture.
Management and Treatment
Complications
Complications of a hip fracture may include reduced independence, shortened life span, and various health issues. After a hip fracture, about half of the affected individuals may not regain the ability to live independently. When hip fractures prevent movement for an extended period, possible complications can involve:
- Shortened leg on the side of the injured hip
- Outward turning of the leg on the side of the injured hip In addition, other potential complications can arise, such as knee or ankle pain, bone infection (osteomyelitis), poor or delayed healing, and nerve or blood vessel damage. Seek immediate medical help if you notice any numbness, pale skin, or circulation problems related to a hip fracture.
Prevention
A hip fracture can be prevented to some extent by taking steps to maintain bone density and avoid falls. Preventive measures include:
- Building bone strength: Consuming calcium-rich foods and taking calcium or vitamin D supplements (if advised by a healthcare provider) can help maintain bone density.
- Proper footwear: Wearing appropriate athletic shoes for different activities and replacing them regularly can help reduce the risk of falls.
- Cross-training: Alternating between activities can help prevent stress fractures.
- Regular weight-bearing exercise: Engaging in activities like walking can help maintain strong bones and muscles, reducing the risk of falls and fractures.
- Adequate nutrition: Consuming adequate calcium and vitamin D through diet or supplements, and maintaining a healthy weight, can help support bone health.
- Avoiding certain medications: Limiting the use of corticosteroids, sleep medications, antipsychotics, and sedatives, as they can increase the risk of falls.
- Lifestyle choices: Maintaining a healthy lifestyle with regular exercise, a balanced diet, and avoiding tobacco and excessive alcohol consumption can help promote bone health and reduce the risk of falls. By implementing these preventive measures, individuals can reduce their risk of experiencing a hip fracture.
Treatment
A hip fracture almost always requires surgical repair or replacement, followed by physical therapy. Treatment options include:
- Hip repair: This involves fixing the broken bone with screws, plates, or rods. The surgeon may use bone grafts to help stabilize the fracture.
- Hip replacement: If the fracture is severe or the bone is too damaged to repair, the surgeon may perform a hip replacement, replacing the damaged joint with an artificial one. After surgery, physical therapy plays a crucial role in recovery. Physical therapists will help patients regain strength, mobility, and flexibility in the affected hip, as well as teach them safe ways to move and walk to prevent future falls. Prompt diagnosis and treatment are critical to complete healing and preventing complications.
Preparing for medical consultation
To prepare for an appointment for a hip fracture, you can:
- Be aware of any pre-appointment restrictions: At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your activities or diet.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. Be specific about the location and severity of pain.
- Make a list of all medications, vitamins, or supplements you're taking, including doses.
- Bring any relevant medical records, imaging results (X-rays, CT scans, or MRIs), and previous reports to the appointment.
- Consider bringing a family member or friend along for support and assistance in remembering the information provided during the appointment. It's essential to communicate openly with your healthcare provider about your symptoms, medical history, and any concerns you may have. This will help them provide the best possible care and guidance for your specific situation.