Causative & risk factors
People belonging to any age group can get a fractured hip resulting from severe trauma to the hip joint. Road accidents, falling from a height etc. are common causes of the same.
Elderly people tend to have weaker bones as a result of osteoporosis. When bones are weak, even minor trauma can lead to fracture of the hip bone. This risk is especially higher in women since they lose their bone density rapidly after menopause sets in.
Other causes of weakening of bones include nutritional deficiencies, diseases of the intestine or thyroid gland, lack of physical activity, overuse of alcohol or tobacco and side-effects of certain medications.
Clinical presentation
A hip fracture presents with severe pain at the hip joint with inability to move the hip immediately after the fall. There is swelling and stiffness at the fracture site and an inability to bear weight on the affected limb. Patient can present with rotation of the limb. The affected limb can become shortened.
A hip fracture takes several months to recover and can give rise to complications like DVT, bedsores, urinary tract infections etc.
Investigations
After noting the patient history and carrying out a physical exam, X-rays of the hip joint are taken to detect the fracture site. Specialized imaging tests such as CT or MRI scan may be necessary.
Treatment
Surgery is the primary form of treatment in hip fractures. Depending upon the extent of fracture, the bones may be aligned with the help of metal plates and screws. Sometimes the head and neck of the femur may have to be replaced with a metal prosthesis, known as ‘Partial hip replacement’.
If the hip joint is severely damaged, a ‘Total hip replacement’ may be necessary in which the upper portion of the femur and the socket are replaced with prostheses.
Medications known as biphosphonates are prescribed to the patient to increase the bone density and reduce the risk of future fractures. The underlying osteoporosis must be corrected.
Physical therapy is recommended post surgery to help achieve a good range of motion.
Recent updates
For hip fractures, men have a two-fold higher mortality compared to women. A recent study showed that the use of Hormone Replacement Therapy, Calcium and Vitamin D3 supplements helps to bring down the incidence of hip fractures.
