One of the most common fractures in the elderly is hip fracture, usually resulting from a fall or a road traffic accident. Their incidence increases with age and the condition of osteoporosis.
Understanding Hip Anatomy
The hip joint is a ball and socket joint that sees the meeting of the hip and thigh bones. The thigh bone’s ball end fits into the hip’s hollow socket.Various muscles, tendons, and ligaments support this joint.
The most common hip fracture is breaking the top of the thigh bone close to the hip. Less frequently, the lower end of the thigh bone closer to the knee can also break.
Symptoms of Hip Fracture
- Usually, people who fall and sustain a hip fracture cannot stand up again.
- Pain will be severe.
- The fractured side will not be able to take any weight.
- Inflammation at the fracture site.
- Shortening of leg length on the fractured side.
- The leg and feet will be turned outwards.
Common Causes & Risk Factors of Hip Fracture
- A road traffic accident can result in a hip fracture, irrespective of age.
- Women are more prone to osteoporosis and hence hip fractures.
- Thyroid problems can cause bone weakening increasing the possibility of fractures.
- Health conditions that make it difficult for the body to absorb calcium also increase fracture risk.
- Falls usually cause hip fractures only in the elderly, and even a fall from a standing height is enough to result in a fracture.
- If the bones are fragile, standing and exerting weight on the legs could also result in a hip fracture.
- In the elderly, poor vision and balance issues can contribute to falls. Medication for other conditions can sometimes affect an older adult’s coordination.
- Hypoglycemia or low blood glucose can also lead to a fall.
Diagnosing Hip Fracture
An orthopedic doctor can identify a hip fracture from the symptoms and the visible displacement of the leg from the normal position. To determine the exact fracture location, an x-ray will be taken. If the x-ray does not reveal any fracture, an MRI will be done to diagnose a hairline fracture (a slight crack in the bone).
Treatment for Hip Fracture
Treatment in most cases will be surgical, and surgery will have to be done within a couple of days of fracture. Surgery will give pain relief and mobilize the patient faster, and getting surgery done quickly also lessens the chances of complications.
In the case of the elderly who are already afflicted with other health conditions, families often question the need for surgery. Without surgery, the patient will be confined to the bed and have continuing pain, and they might develop bed sores and other conditions, making it even more difficult to care for them.
Very rare cases will have non-invasive surgical options suggested.
Non-Invasive Treatment for Hip Fracture
- If the fracture has not displaced the bones and they have stayed in place, the doctor will advise the patient to refrain from putting any weight on the affected bone for 1 – 1½ months.
- Walking aids or a wheelchair can be used during this period.
- However, not putting on weight does not mean physical inactivity as it might weaken muscles and lead to other conditions.
- The doctor will suggest stretching and mobility exercises maintain blood circulation and muscle strength.
- To help deal with the pain during the healing process, the doctor will give pain medication so the patient can perform the suggested exercises.
- Once the patient is fit to resume walking, additional exercises will be given to strengthening bones and muscles further.
The type of surgical intervention depends on the location of the fracture, the severity, and the patient’s age and medical history.
- Internal Fixture: The fractured bone needs to be supported till it can withstand any weight again. During this procedure, the doctor will set the bones in place and use metal plates, screws, and other hardware to hold them properly. This procedure will help the patient regain mobility faster and prevent fracture malunions and non-unions.
- Partial Hip Replacement: In the case of a partial hip replacement, either the ball head or the socket is replaced with a prosthetic, depending on which part has been damaged. The other part is left as it is.
- Total Hip Replacement: In a total hip replacement, the damaged ball head of the thigh bone and the broken hip joint socket is replaced with prosthetics. Age is not a criterion for total hip replacement, and the doctor will recommend the procedure depending on how restrictive the pain is. The procedure has a high success rate, and patients experience significant pain reduction and increased mobility after it.
The doctor will discuss all treatment options with the patient and his family to arrive at the best treatment plan for the patient.
Preventing Hip Fractures
The process of prevention can begin from early childhood itself. When parents encourage a healthy lifestyle in their children byensuring they eat a balanced diet and get enough physical activity, the bones develop stronger. Carrying this healthy lifestyle into adulthood will significantly reduce fracture risk. However, it is never too late to start anything beneficial. Starting physical activity at any age is bound to pay off – not only will fracture risk reduce but overall well-being will improve significantly.
- Please make sure the body gets its calcium and vitamin D requirements. An orthopedic doctor can help with the dosage.
- Low-impact exercises like jogging will keep bones strong. Balance exercises are also essential to prevent falls.
- Regular vision checks to make sure eyesight is normal.
- Maintain optimal weight and reduce pressure on the joints.
- Quit smoking and avoid alcohol as much as possible.
- Fall Prevention: Make sure the house is free of clutter – wires on the floor should be pinned to the wall sides, mats and rugs should be anti-slip and stable, and the floor should be kept as free as possible. Adequate lighting also plays a huge role in preventing falls.