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Hip Fracture

Definition


Disease: Hip Fracture Hip Fracture
Category: Bones, joints, muscles diseases
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Disease Definition:

Hip fractures are quite common in people older than 65. However, they could occur at any age. Bones slowly lose their minerals and become less dense as a person ages. The hip will be more susceptible to fracture due to gradual loss of density which weakens the bones.

Because women lose bone density as they age at a greater rate than men do, they are more likely to experience a hip fracture.

A hip fracture could be a serious injury with life-threatening complications, particularly in older people. Even though recovery usually requires time and patience, surgery to repair a hip fracture is usually very effective.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Some of the signs and symptoms of a hip fracture may be:

-    Stiffness, bruising and swelling in and around the hip area
-    Turning outward of the leg on the side of the injured hip
-    Severe pain in the hip or groin
-    Shorter leg on the side of the injured hip
-    Inability to put weight on the leg on the side of the injured hip.

Causes:

A hip fracture in older adults is usually the result of a traumatic event, such as falling and weak bones. Major trauma to the hip, such as a car accident or sports injury, could lead to a hip fracture in younger adults.

Complications

Complications:

A hip fracture is a serious injury. Complications of a hip fracture could be life-threatening, despite the fact that the fracture itself is treatable. The doctor may use a tension system (traction) to allow the hip to heal in case the person also has an illness that makes it unsafe to undergo surgery to repair the broken hip.

Traction keeps the person immobile for a long period; during this time the patient may develop blood clots in the veins of their legs. In case the patient doesn't get up and move around very much, they could also develop a blood clot after hip surgery. A blood clot could block blood flow to lung tissue in case it becomes lodged in a pulmonary artery. This condition, called a pulmonary embolism, could be fatal.

Some of the other risks of traction and being immobile may include:

-    Muscle wasting
-    Urinary tract infection
-    Bedsores
-    Pneumonia

People who've had one hip fracture usually have a significant risk of having another one.

Treatments:

The best treatment for hip fracture is almost always surgery. However, in case someone has a serious illness that makes surgery too risky, nonsurgical alternatives could be used, such as traction.

Generally, the type of surgery will depend on:

-    The part of the hip that fractured
-    The severity of the fracture
-    The patient's age.

Usually, the chances for a complete recovery from a hip fracture will be greater, the better the patient's health and mobility were before the hip fracture.



FEMORAL NECK FRACTURES:

There are three methods to repair a femoral neck fracture:

Replacement of part of the femur:
In the procedure known as hemiarthroplasy, the head and neck of the femur may be removed and replaced with a metal prosthesis in case the ends of the broken bone aren't properly aligned or if they've been damaged.

Metal screws:
After the break, in case the bone is still properly aligned, metal screws could be inserted into the bone in order to hold it together while the fracture heals. This method is called internal fixation.

Total hip replacement:
In this procedure, the upper femur and the socket in the pelvic bone will be replaced with a prosthesis. In case arthritis or a prior injury has damaged the joint and affected its function prior to the fracture, a total hip replacement could be a good option.

The older the patient is, the more likely they will receive a prosthesis because older adults aren't likely to wear out a prosthesis and so won't need additional surgery. In order to prevent serious complications, it's quite important for older adults to get moving again quickly after surgery.

Intertrochanteric region fractures:
A metal screw called a hip compression screw will be inserted across the fracture in order to repair this type of fracture. The screw will be attached to a plate that runs down alongside the femur and in order to keep the bone stable, it will also be attached with other screws. The screw will allow the bone pieces to compress as the bone heals, so that the edges grow together.

Usually, after a hip fracture surgery, hospital stays last less than a week. However, the patient may continue to meet with a physical therapist after they get out of the hospital. After a hip surgery, people who can't bear weight on their hip and don't have assistance at home will be required to stay at an extended care facility.



MEDICATIONS:

The primary treatment for a hip fracture is surgery. However, a study has found that in treatment of hip fracture, once-yearly infusions with the intravenous medication zoledronic acid could be helpful. Additionally, the rates of new fractures have been found to be reduced and survival odds improved in case zoledronic acid is started within three months of the fracture.

Prognosis:

Not available

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