What is hip fracture?

Hip fracture

A hip fracture is a break in the upper part of the thighbone (femur) where the thighbone joins the pelvis to form the hip joint. Most hip fractures occur in the area just below the ball of the femur (femoral neck region) and the area just below this (intertrochanteric region).

A hip fracture almost always completely breaks the bone. A partial break in the bone (hairline fracture) may occur but is not as common and may not show up on an X-ray.

In older adults, hip fractures are caused most often by a fall. Even a slight fall can sometimes cause a fracture in a weakened hipbone. Women, especially those in their late 70s and 80s, are at an increased risk for hip fractures due to osteoporosis. This condition causes the bones to become thin and brittle.

In children and young adults, hip fractures are caused most often by a sudden, severe injury, such as a vehicle accident, sports injury, or a high-impact fall.

The most effective and common treatment for a hip fracture is surgery.

What happens when you have a hip fracture?

After a hip fracture, you'll likely need surgery. It can take as long as a year to recover.

Some people aren't ever able to get around as well as they could before. They may need to use a walker or cane. They may need help with daily activities such as dressing and bathing. And many can no longer live on their own.

But working hard in physical therapy or a rehab program can help you get back some strength and mobility, which can help you be as independent as possible.

What are the symptoms of a hip fracture?

If your hip is broken, you will most likely:

  • Have severe pain in your hip or lower groin area.
  • Not be able to walk or put any weight on your leg.

These symptoms are most common after a fall. But if you have very thin bones from osteoporosis or another problem, you could break your hip without falling.

In rare cases, people have only thigh or knee pain. They may be able to walk.

How is a hip fracture treated?

You will most likely need surgery to fix your hip. Surgery usually works well, but your hip will probably take a long time to get better.

Surgery is done as soon as possible after a hip fracture is diagnosed, often within 24 hours. Having surgery right away may help shorten your stay in the hospital. It can also reduce pain and problems from the surgery. Sometimes surgery is delayed for 1 to 2 days so other medical problems can be treated first.

The type of surgery you have will depend on where the break is and how bad it is.

  • Hip repair surgery is called internal fixation or "hip pinning." The doctor uses metal screws, rods, or plates to hold the bone together while it heals. This surgery is usually chosen if the bones can be lined up properly.
  • Hip replacement surgery involves replacing part or all of the joint with artificial parts. In a partial hip replacement, the doctor replaces the broken upper part of the thighbone. In a total hip replacement, both the hip socket and the top of the thigh bone are replaced. Total hip replacement is often done when the fractured bones can't be properly lined up.

Your doctor will encourage you to take part in a rehab program that includes physical therapy and occupational therapy. This will teach you:

  • Exercises to help you regain your strength and mobility.
  • New ways to do simple daily activities.
  • Safe ways to stay active.

Taking part in a rehab program is very important because it will speed up your recovery. Rehab can also help you get back to your normal activities sooner.

How can you prevent a hip fracture?

There are many things you can do to prevent a hip fracture. One of the most important is to prevent osteoporosis. Bone thinning can happen to men or women. But it is more common in women.

To keep your bones strong:

  • Get plenty of calcium and vitamin D. Dairy foods like milk, cheese, and yogurt have lots of calcium. It's also in some vegetables like broccoli and kale. Vitamin D is in foods such as salmon, tuna, and fortified milk and cereals. If you want to take supplements, ask your doctor how much you need.
  • Limit alcohol to no more than 1 drink a day for women and no more than 2 drinks a day for men.
  • Do weight-bearing exercise that puts pressure on bones and muscles. Walking is a good choice.
  • If your doctor prescribes medicine to slow osteoporosis, take it as directed.
  • Don't smoke.

You also need to be extra careful to prevent falls. Here are a few ways to make your home safer:

  • Get rid of throw rugs, and keep walkways clear of electrical cords and clutter.
  • Be sure you have good lighting where you are walking.
  • Put grab bars and nonslip mats in showers and tubs.

It can also help to:

  • Get your eyes checked on a regular basis.
  • Exercise to help keep your strength and balance.
  • Take medicines as directed. And from time to time, ask your primary care doctor to review your medicines. Some medicines, such as sleeping pills or pain relievers, can increase your risk of falling.

How is a hip fracture diagnosed?

Doctors use X-rays to diagnose a broken hip. You may need another test if your doctor thinks that you have a fracture but can't see it on an X-ray. You might have a test such as:

  • An MRI, which gives better images of bones and soft tissues.
  • A CT scan, another way of getting more detailed images.
  • A bone scan, which involves injecting a dye, then taking images. It can show hairline fractures, where the bone is cracked but the pieces are still in place.

What puts you at risk for hip fractures?

One of the things that puts you at risk for a hip fracture is osteoporosis. This disease makes your bones thin, brittle, and easy to break.

Both osteoporosis and hip fracture affect women more often than men. This happens because men have higher bone density than women and because of the decrease in the hormone estrogen in women after menopause. Having lower levels of estrogen speeds up bone loss and results in weakened bones. Lower levels of testosterone in men can also speed up bone loss.

Although men are also at risk for hip fracture as they age, women have lower bone density to begin with, more bone loss after middle age, and live longer than men. As a result, most hip fractures occur in women.

Some medicines are related to bone loss or to fractures. These include:

  • Antacids that contain aluminum.
  • Steroids used to treat conditions such as asthma and chronic obstructive pulmonary disease (COPD).
  • Some antidepressant medicines.

Other things that put you at risk for hip fracture include:

  • Your family history (heredity). Being thin or tall, or having family members who had fractures later in life increases your risk.
  • Being white or Asian. They have a higher risk of osteoporosis. Osteoporosis raises the risk of a fracture if you fall.
  • Not getting enough calcium and Vitamin D. Both are needed for building healthy, strong bones.
  • Smoking. This puts you at a higher risk for osteoporosis. It also increases the rate of bone thinning after it starts.
  • Drinking alcohol. Having more than 2 alcoholic drinks a day for men or 1 alcohol drink a day for women puts you at higher risk for osteoporosis. Alcohol use also raises your risk of falling and breaking a bone.
  • Not being active. Moderate amounts of weight-bearing exercise, such as walking and dancing, can help keep bones strong.
  • Having certain medical conditions. Some can cause problems with balance or dizziness. One example is Ménière's disease. Other conditions such as arthritis can make it hard to be steady as you walk and move.
  • Drug interactions. Sometimes one medicine you are taking changes the action of another medicine, or the drugs react to each other. This interaction can create unexpected side effects. These can include dizziness or blurred vision that make falls more likely.

What is a hip fracture?

A hip fracture is a break in the upper part of the thighbone (femur). It usually happens near where the thighbone fits into the hip joint. A hip fracture almost always completely breaks the bone. It can take some time to recover. But treatment can help you get back some strength and mobility.

What causes hip fractures?

Most hip fractures are caused by falls. As you get older, your bones naturally lose some strength and are more likely to break, even from a minor fall. Children and young adults are more likely to break a hip because of a bike or car accident or a sports injury.

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