Article by Dr. Darren R Keiser MD
Hip fractures cause a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat hip fractures is primarily based on the bones and soft tissues affected or on the level of the fracture.
The “hip” is a ball-and-socket joint. It allows the upper leg to bend and rotate at the pelvis. An injury to the socket, or acetabulum, itself is not considered a “hip fracture.” Management of fractures to the socket is a completely different consideration.
Hip fractures most commonly occur from a fall or from a direct blow to the side of the hip. Some medical conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking. In severe cases, it is possible for the hip to break with the patient merely standing on the leg and twisting.
The patient with a hip fracture will have pain over the outer upper thigh or in the groin. There will be significant discomfort with any attempt to flex or rotate the hip.
If the bone has been weakened by disease (such as a stress injury or cancer), the patient may notice aching in the groin or thigh area for a period of time before the break. If the bone is completely broken, the leg may appear to be shorter than the noninjured leg. The patient will often hold the injured leg in a still position with the foot and knee turned outward (external rotation).
Patients may be discharged from the hospital to their home or find that a stay in a rehabilitation facility is necessary to assist them in regaining their ability to walk.
Patients may be encouraged to get out of bed on the day following surgery with the assistance of a physical therapist. The amount of weight that is allowed to be placed on the injured leg will be determined by the surgeon and is generally a function of the type of fracture and repair (fixation).
The physical therapist will work with the patient to help regain strength and the ability to walk. This process may take up to three months.
Occasionally, a blood transfusion may be required after surgery, but longer term antibiotics are generally not necessary. Most patients will be placed on medicine to thin their blood to reduce the chances of developing blood clots for up to 6 weeks. These medicines may be in the form of pills or injections. Elastic compression stockings or inflatable compression boots may also be used.
During the appointments that take place after surgery, the surgeon will want to check the wound, remove sutures, follow the healing process using X-rays, and prescribe additional physical therapy, if necessary.
Following hip fracture surgery, most patients will regain much, if not all, of the mobility and independence they had before the injury.
**Call the office of Dr. Darren Keiser to set up an appointment
Article URL: http://orthoinfo.aaos.org/topic.cfm?topic=A00392&webid=2FDDE053