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Hip fracture


A hip fracture or broken hip is unfortunately a common injury in older Australians. Risk factors for broken hip increase with age as our bones become weaker and more prone to damage. 


 

In this article


 

What is a hip fracture?

Hip fractures usually occur in the upper femur (thigh bone). Hip fractures can also involve the intertrochanteric region, the part of your upper femur that sticks out from the hip.

The hip joint is a ball and socket joint. The top of the thigh bone or femur is shaped like a ball and fits neatly into the cup of the acetabelum (pelvis). The hip joint is relatively stable and has a wide range of movement.  


 

What causes hip fracture?

A broken hip is usually caused by a fall or direct injury. However, many factors can increase the risk of falls and broken hip in older people. Conditions such as osteoporosis cause the bones to become frail and brittle. For someone with osteoporosis a small trip can result in a broken hip.

Loss of vision, poor balance, certain medications and environmental factors can also increase the risk of a broken hip in older people.

Many older people fall and are hospitalised for broken hip every year and although a broken hip is manageable a hip fracture can lead to serious disability, post operative complications and in some cases death.


 

Hip fracture symptoms

Symptoms of hip fracture will depend on the extent of the injury.  Some people with weakened bones can experience aching in the thigh or groin some time before the break.

Signs of a broken hip or hip fracture include:
    •    Pain in the outer upper thigh or groin
    •    Difficulty and discomfort flexing or rotating the hip
    •    The affected leg will appear shorter and rotate outwards
    •    Stiffness, bruising, swelling around hip area
    •    Unable to place weight on hip 

Source (American Academy of Orthopeadic Surgeons 2009).

If a loved one falls and has any signs of broken hip seek medical help immediately by calling 000.


 

Diagnosis of hip fracture

Diagnosis of hip fracture will be made after an xray. An xray will determine the location and type of fracture. If a fracture cannot be seen on an xray a doctor may take an MRI, CT or bone scan.

Types of broken hip

There are different types of hip fractures. Hip fractures are classified according to the location and the severity of the fracture at the upper femur.

Fractures of the hip can involve different parts of the femur (thigh bone) and hip joint. Generally hip fractures occur at the head of the femur or "ball" but they can also involve the hip joint or "socket". 


 

Hip fracture surgery

Surgery is the treatment of choice for most broken hips. The type of surgery used to treat hip fracture will depend on the type and extent of the hip fracture. Surgery for broken hip will in most cases be as soon as possible.

Before surgery other factors including the person's age, general health and existing medical conditions will be taken into account. If a person is healthy and mobile before a hip fracture the outcome of surgery is generally more successful.
 
Surgery may include inserting metal screws to stabilise and heal a fracture. A partial hip replacement is where a prosthesis is implanted in the joint to replace broken bone at the head and neck of the femur. A total hip replacement is where both the ball and socket, or head of the femur and acetabulum is replaced with a prosthesis.

In some cases treatment of broken hip is not recommended. Non- surgical treatment of broken hip may be advised in older people who were confined to bed previous to their injury or too ill to undergo surgery. This may include people with late stage dementia or people who have a high likelihood of post operative complications. 


 

Complications of hip fracture

Many people are surprised when they are encouraged after hip surgery to mobilise early on. It is important for a person to regain strength and mobility a soon as possible after a broken hip. Older people with multiple medical conditions are at risk of numerous post operative complications. These include bedsores, pneumonia, blood clots and infection.

The experience of broken hip surgery and simply being immobile can be very painful. Extended periods of bedrest can eventually lead to muscle wastage. Some people will need constant reassurance and support especially if they are fearful of falling again.

Medications will help your loved one cope with the pain. Side effects of pain medications can include constipation and increased confusion. 

Recovering from hip fracture can be slow and complex but with good care over time many older people regain their independence. 


 

 

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References

American Academy of Orthopaedic Surgeons
Hip Fractures
Accessed 31/04/09

American Academy of Orthopaedic Surgeons
Total Hip Replacement
Accessed 31/04/09