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Hip Fracture

Definition

A hip fracture is a break in the thigh bone just below the hip joint. The hip joint consists of a ball at the top of the thigh bone and a rounded socket in the pelvis. Most hip fractures occur 1-2 inches below the ball portion of the hip in the neck of the thigh bone.
Hip Fracture
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Causes

Factors that may contribute to a hip fracture include:
  • Falls—the most frequent cause
  • Motor vehicle accidents and other types of major trauma
  • Stress fractures in athletes—rare
  • Bone conditions such as osteomalacia—rare
  • Bone tumors—rare

Risk Factors

Factors that increases your chance of getting a hip fracture include:
  • Previous hip fracture or history of falling
  • Age: 65 years or older
  • Sex: female, especially after menopause
  • Heredity
    • Family history of fractures later in life
    • Small-boned, slender body—low body weight
    • Caucasian or Asian race
  • Others:
    • Osteoporosis—a bone-thinning condition that weakens all bones
    • Poor nutrition
    • Deficient intake or absorption of calcium and vitamin D
    • Low body weight
    • Physical inactivity
    • Weakness
    • Poor balance and coordination
    • Smoking
    • Excessive alcohol use
    • Chronic disease or fragile health
    • Diabetes
    • Kidney disease
    • Irregular heart beat or low blood pressure
    • Arthritis
    • Parkinson's disease
    • History of stroke
    • Mental impairments including Alzheimer’s disease
    • Problems with vision
    • Certain medications which cause lightheadedness, drowsiness, or weakness
    • Cortisone or other steroids
    • Thyroid disorder
    • Heart failure

Symptoms

Symptoms may include:
  • Pain in the hip
  • Difficulty or inability to stand, walk, or move the hip
  • Abnormal appearance of the broken leg:
    • Looks shorter
    • Turns outward

Diagnosis

The doctor will ask about your symptoms and how the injury occurred. A physical exam will be done.
Images may be taken of your bones. This can be done with:

Treatment

The goal is to get you back on your feet as quickly as possible while your broken bone heals. For older patients, staying in bed for even several days may lead to serious complications.
Treatment includes:

Prompt Emergency Treatment

  • Taking all weight off the injured leg and immobilizing the fracture
  • Checking vital signs such as blood pressure
  • Treating problems such as internal blood loss
  • Pain control with pain killers and other drugs

Surgery

Surgery is performed. This may involve:
  • Inserting a surgical plate and screws at the fracture site
  • Replacing the hip with a metal implant, which has a ball that fits into the hip socket and an attached stem which goes into the thigh bone to hold the implant in place

Physical Assistance

You may require:
  • Exercises or therapy to help you return to your normal level of activity
  • A cane or walker as advised by your doctor
  • Help with activities of daily living
If you are diagnosed with a hip fracture, follow your doctor's instructions.
If you are diagnosed with a hip fracture, follow your doctor's instructions.

Prevention

Early corrective action may help lessen many of the factors that can lead to a hip fracture. Here's what you can do:
  • Eat a diet with nutrients for strong bones such as calcium,vitamin D, and protein.
  • Ask your doctor before you begin exercising. Exercises should include weight-bearing activities and strengthening exercises.
  • Talk to your doctor if you are at risk for osteoporosis.
  • Ask your doctor if any of your medications may contribute to bone loss or symptoms of lightheadedness, drowsiness, or confusion.
  • Get your eyes checked regularly.
  • Reduce falling hazards at work and home:
    • Clean spills and slippery areas right away.
    • Remove tripping hazards such as loose cords, rugs, and clutter.
    • Use non-slip mats in the bathtub and shower.
    • Install grab bars next to the toilet and in the shower or tub.
    • Put in handrails on both sides of stairways.
    • Walk only in well-lit rooms, stairs, and halls.
    • Keep flashlights on hand in case of a power outage.

RESOURCES

American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org

American Academy of Family Physicians http://familydoctor.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Feskanich D, Willett W, Colditz G. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA. 2002;288:2300-2306.

Hip fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 24, 2013. Accessed May 7, 2013.

Hip fracture prevention. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00309. Updated January 2013. Accessed May 7, 2013.

11/6/2009 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Sennerby U, Melhus H, Gedeborg R, et al. Cardiovascular diseases and risk of hip fracture. JAMA. 2009;302(15):1666-1673. van Diepen S, Majumdar SR, Bakal JA, McAlister FA, Ezekowitz JA. Heart failure is a risk factor for orthopedic fracture: a population-based analysis of 16,294 patients. Circulation. 2008;118(19):1946-52.

1/4/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Lee JS, Buzková P, Fink HA, et al. Subclinical thyroid dysfunction and incident hip fracture in older adults. Arch Intern Med. 2010;170(21):1876-1883.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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