A hip fracture is another term for a broken hip. It is a complete or partial break in the top part of the thighbone. The thighbone, also called the femur, inserts into the hip joint.
What are the causes and risks of the injury?
A broken hip is most often the result of an injury. Falls and car accidents are the most common sources of these injuries. Factors that increase a person's risk of hip fracture include:
- normal aging, which causes the bones to become more brittle
- osteoporosis, or excess bone thinning that results from loss of calcium in the bone
- menopause. During menopause, the ovaries stop making estrogen, which normally protects against bone loss.
- removal of the ovaries
- diet low in calcium or vitamin D
- sedentary lifestyle
- eating disorders such as anorexia and bulimia
- family history of osteoporosis
- medications such as corticosteroids, certain medications for seizures, and some medications used for high blood pressure
- excess alcohol intake
- hyperthyroidism, a condition in which the thyroid gland makes too much thyroid hormone
- hypogonadism, a condition in which the ovaries in women or testes in men do not function normally
- hyperparathyroidism, a condition in which the parathyroid gland makes too much parathyroid hormone. This hormone can affect calcium levels in the bloodstream and weaken bone further.
- rheumatoid arthritis, a condition in which the body attacks its own joint tissue
- cancers affecting the bone
- physical abuse, including child abuse, elder abuse, and spousal abuse
What can be done to prevent the injury?
Some fractures can be prevented by following sports safety guidelines for children, adolescents, and adults.
Bone loss, which increases a person's risk of hip fractures, can be slowed by doing 30 minutes of moderate weight-bearing exercise a day. Weight-bearing exercise includes low-impact aerobics, walking, running, lifting weights, tennis, and step aerobics. A person doing moderate exercise can talk normally without shortness of breath and is comfortable with the pace of the activity. The 30 minutes a day can be done all in 1 session or broken up into smaller segments of time.
Low-impact aerobics and water aerobics are examples of exercises that minimize joint stress in elderly individuals or people with arthritis. Recent research has shown that people who participate in high-impact activities such as jogging have less bone loss as they age.
Individuals can lower their risk of hip fractures following osteoporosis by:
- eating a well-balanced diet, following the food guide pyramid. A diet with adequate calcium and vitamin D can help slow bone loss. There is some evidence that too much bone thinning is hastened by a diet high in fat.
- eating 25 grams of soy protein daily
- avoiding smoking
- limiting alcohol intake
- for women who have reached menopause, using hormone replacement therapy
- getting effective treatment for conditions such as hypogonadism, rheumatoid arthritis, and hypothyroidism
How is the injury recognized?
Diagnosis of a hip fracture begins with a history and physical examination. The diagnosis can be confirmed with a joint X-ray.
What are the treatments for the injury?
Treatment will depend on the location, type, and severity of the fracture. Individuals must also be checked for other medical problems to see if they can handle the stress of surgery. Several weeks in a splint or cast may be all that is needed for mild fractures in certain locations.
Many hip fractures will need immediate surgery, known as a hip pinning . Leg traction, which is a pulling pressure applied to the leg, may be used before surgery. During surgery, the broken bone parts are put back in place. Often, they are secured with special metal pins.
In some cases, part or all of the hip joint needs to be replaced in a procedure known as a hip joint replacement. This procedure is more likely if the person has severe arthritis involving the hip joint or if the bones making up the hip are broken into several pieces.
What are the side effects of the treatments?
Long periods of bed rest can be harmful for elderly people with broken hips. Prolonged immobility puts individuals at greater risk for blood clots and lung infections such as pneumonia. Surgery may cause bleeding, infection, and allergic reaction to anesthesia.
What happens after treatment for the injury?
Physical therapy may be needed after surgery or cast removal. The person will need to use a walker or crutches at first. Many people make a full recovery after surgery. Any new or worsening symptoms should be reported to the healthcare provider.
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