Over 65? Watch Out for Hip Fractures

Small rugs placed around the house. Uneven steps. No handrails on the stairs. Add to these ingredients a female over age 65 and you have the formula for a fractured hip.

More than 90% of hip fractures are caused by falling. And women suffer 75% of all hip fractures. Why more women than men?

“Primarily because women are more likely to suffer osteoporosis, a weakening of the bones due to loss of mineral. The bone becomes more fragile and it takes less force to break, explains Orthopaedic Surgeon Nigel Watt. “As our baby boomer population ages and with increased life spans, we expect to see an increase in hip fractures.”

DIAGNOSING HIP FRACTURES
Although hip fractures are usually accompanied by severe pain and inability to bear weight through the limb, some patients are able to walk with only limited pain and may be unaware of the seriousness of their injury.

Delays in seeking a diagnosis and treatment can end up increasing the severity of the injury and, even after repair, reducing your ultimate quality of life.

Your personal physician or an Orthopedic Specialist will take X-rays or, in some cases, an MRI to evaluate the area affected. Treatment, usually surgical, can be undertaken quickly.

HIP FRACTURE TREATMENT
Treatment is selected with the goal of relieving pain in the immediate and long term, restoring medical stability, achieving optimum recovery from the fracture and improving the person’s quality of life, hopefully, to the pre-fracture level of function and independence.

Treatment of the patient with a broken hip often involves managing multiple other medical conditions that may have contributed to the fall or may complicate safe completion of surgical and other treatments and these may require correction before or after surgery.

The surgical procedure recommended depends on the exact location of the fracture and the position and shape of the broken pieces.

The bone involved when surgery is needed is usually the upper end of the femur (thigh bone) and there are two main types.

  1. Extra-articular. The fracture is not inside the hip joint itself and the surgical goal is to fix the pieces securely back together to allow the bone to move immediately as one piece, relieve pain and allow healing of the pieces in as close to normal position as possible. This is by “internal fixation” usually by a combination of a plate or rod and screws between the fragments.
  2. Intra-articular. Here the fracture is inside the hip joint. The choice and success of surgery will depend on the position of the pieces. If they are not out of place then internal fixation with screws may be sufficient. If the pieces are out of place then a more reliable outcome may be achieved by removing the broken hip ball (the femoral “head”) and replacing it – performing a hip replacement. The hip socket will often be undamaged and so a partial replacement (“hemiarthroplasty”) may be the safest and most successful operation.

Total Hip Replacement may be the recommended treatment in younger patients, particularly if the person has few or no other medical problems and is more active.

In all patients the overall aim is to restore mobility and return to comfortable, safe independence as soon as possible.

Download information from the CDC on preventing falls that lead to hip fractures.

Find an Orthopedic Specialist near you.

Sources include: McLeod Health, American Academy of Orthopaedic Surgeons, National Institutes of Health, American Association of Family Physicians, US Centers for Disease Control & Prevention, National Health Service (UK)