Hip Fracture Basics: Types and Causes of Broken Hips
Hip fractures are serious injuries that often require surgery to repair. Every year in the United States alone over 300,000 people suffer broken hips and require hospitalization. Of that number, over half of those people experiencing a hip fracture are over the age of 80.
Bone density, age, and other medical conditions can all contribute to the likelihood of a broken hip, but generally a fracture occurs because of some sort of trauma to the area, like a fall. Most hip fractures in the elderly are caused by falls, while in younger patients – car accidents and other high impact injuries are the most likely causes.
Elderly women and other patients with osteoporosis are at a greater risk of experiencing a broken hip in the event of a fall. Because osteoporosis weakens the skeletal system by causing loss of bone mass – bones and joints are at a greater risk of fracturing in the event of trauma.
Hip fractures are truly the breaking of the femur (the bone that extends from the pelvis to the knee) inside or near the hip joint. Hip fractures are generally placed into 2 main classifications – a Femoral Neck Fracture or an Intertrochanteric Fracture. Both of these types of fractures are very serious and in most situations will necessitate surgery to repair the fractures.
Femoral Neck Fracture
The femoral neck is just below the head (top) of the femur. A femoral neck fracture generally occurs within 1 to 2 inches from the end of the femur.
This fracture occurs within 3 to 4 inches of the head of the femur and usually requires the use of a metal plate and screw to keep up the bone in place while it heals – allowing the head of the femur to continue moving typically in the hip socket.
Though hip fractures are generally caused by a serious trauma – a fall or a high impact injury – other factors can contribute to the risk of sustaining a broken hip.
Statistics show that age is a large factor. The majority of hip related injuries and fractures occur in people over 80. There are two main reasons why this may be true: bone density loss and the presence of other medical conditions affecting balance and mobility. But also effecting elderly patients are general aging issues like loss of vision and a decreasing or weakening sense of balance.
Osteoporosis puts patients at an already higher risk for breaking a hip simply because it reduces bone density. There are a number of other medical conditions that will also rule up to and increase chances of developing osteoporosis which in turn can rule to increased risks for hip fractures.
The development of other diseases and conditions like Parkinson’s disease which effect a person’s mobility and balance can contribute to an increased risk of falling and breaking a hip in addition. Diabetes, arthritis, and similar diseases can also effect a person’s activity levels which in turn increases risk.
Because physical inactivity can rule to the weakening of bones, tendons, and muscles – it can also contribute to a higher risk of fracturing basic bones and joints. Physical inactivity can in turn rule to other conditions such as obesity and weight gain which can put a larger strain on a weakening bone structure. Maintaining a regular physical activity schedule will often reduce a patient’s risk of hip fracture.
Mortality Rates and shared Problems Associated with Hip Fractures
Hip fractures are serious injuries that require immediate medical attention because there are a number of problems and conditions that can arise because of the broken bone. Studies have shown that mortality rates following a hip fracture can be rather high for a number of reasons which include the development of other serious medical conditions (blood clots and infections) in addition as the age of the patient at the time of the injury (since the majority of fractures occurs among seniors).
A study published in the British Medical Journal places mortality rates within one year of experiencing a fractured hip at 20%. And this number only increases with the age of the patient – as many as 33% of patients over the age of 80 die within a year of breaking a hip. The 30 day mark following surgery for a fractured hip is high in this population also – coming in at about 10%.
A number of factors contribute to these high numbers. Post-operative complications like infections (i.e. pneumonia or bronchitis) are dangerous factors. The general health of the patients involved in the study also contributes to the high mortality rates. Because as we talked about, a number of other conditions can increase a patients risk of breaking a hip. These same conditions (obesity, diabetes, osteoporosis, Parkinson’s, and others) can also make recovery more difficult.
Mobility factors increase risk in addition. Because a broken hip makes it already more difficult for patients to get proper exercise, the overall decline of the body due to inactivity can bring about other health problems or exasperate existing conditions like heart disease. For patients that are bedridden following surgery, pressure sores and infections become an increased risk.
Overall, the general health of a patient prior to the consistent injury and following surgery is going to play highly in calculating the likelihood of the patient’s complete recovery. This is why younger patients tend to retrieve more completely and quickly as they are less likely to have preexisting medical conditions that are going to be worsened by the injury.
Mortality rates and other complications decline considerably in patients that work hard at maintaining an active and healthy lifestyle in spite of of age. Often for these folks – a broken hip is a permanent setback, though it is nevertheless a serious injury. Recovery though will often be a lot simpler if the patient has maintained general good health prior to fracturing their hip.
How Hip Fractures are Treated
In most situations, a hip fracture is going to require surgery. In situations where surgery is not possible because of an illness or other factor – traction may be used. In those situations without surgery – the main treatment for a broken hip relies mainly on pain reduction.
Both types of hip fractures – the femoral neck fracture and the intertrochanteric fracture – require surgery. The exact procedure is slightly different for each kind.
Intertrochanteric Fracture Surgery
When the break is lower on the femur as in an intertrochanteric fracture (occurring 3 to 4 inches from the head of the femur) a different procedure is generally used. Doctors will attach a metal plate to the side of the femur and insert a metal hip compression screw into the femur. This compression screw and plate allows the bone particles to compress together and mend themselves.
Femoral Neck Fracture Surgery
With a femoral neck fracture, surgery will generally include one of three types of procedures: metal screws, replacing part of the femur, or total hip substitute.
Using metal screws, the surgeon will align the bones and fix them in place with three long metal screws which will keep in place and not be removed. These screws serve to allow the bones to mend back together in addition as strengthen that section of the femur.
If the doctors are unable to align the bones in a way that will allow them to heal properly, they will usually attempt a procedure known as a hemiarthroplasty. This involves removing and replacing the damaged head and neck of the femur with a metal prosthesis.
Total hip substitute is the most invasive of the three options. If for some reason, the socket joint in the hip is damaged – total hip substitute might be the best option. In this procedure, the surgeons will not only replace the top portion of the femur, but also the joint section of the pelvic bone. One of the benefits of total hip substitute is that it allows patients to become mobile again sooner after the surgery than other options. This can help to prevent other complications associated with major surgery from developing.
Hospital stays after surgery for a hip fracture can vary in length – although the average stay in the hospital generally lasts a week. The majority of patients will require physical therapy for a long period following the surgery to retrieve completely. Older and less mobile patients may already have to look to a long term care facility if they don’t have obtainable help or care at home.
Help With Recovery and Prevention of Hip Fractures
Exercise and physical activity is a meaningful in helping with both recovery from a hip fracture and prevention of those fractures. Because mobility is limited following surgery for hip fractures, the use of a rolling walker is often a good idea for elderly patients as it will help them get the exercise to speed up healing and also help to prevent another fall from irritating the injury further.
Everyday responsibilities will probably become a little more difficult for a patient recovering from hip fracture surgery. Things like bending over to tie shoes or getting dressed in the morning will require a little bit of additional effort. Lifting the affected leg into bed or onto the couch will also become more difficult at times during the recovery. There are quite a few products like extended shoe horns and leg lifters which can ease the pain and difficulty of recovery.
Often times, simple responsibilities that are taken for granted become more complicated. Bathing for example is an everyday thing that becomes tough following hip surgery. A sponge on an extended manager or a bath bench become tools which can really help.
To make recovery easier, the buy of a “hip kit” is a small investment for quite a bit of help. shared items that you’ll find in a hip kit include:
- Long Handled Sponges
- Long Handled Shoe Horn
- A Dressing Stick
- Extendable Reachers or Grabbers
- Leg Lifters
Mobility and physical therapy are both important factors in helping to speed up recovery. complete use of the hip will take some time, but in patients that were healthy prior to the surgery, a complete recovery is possible and likely.
Exercise is a major factor in recovery in addition as the prevention of other complications arising because of the surgery. Any help that a patient can enlist – either from family or qualified medical practitioners is going to aid them in recovery.
Learning how to prevent falls is another factor that is going to seriously limit the likelihood of breaking a hip.
* Building railings or ramps to help with stairs around the home is a good idea.
* Installing rails next to the toilet and in the bathtub or shower is another preventative measure. They’re also great ideas to help somebody who is trying to retrieve from hip surgery since their mobility will be more limited for a time.
* Rearranging furniture to allow for clear paths.
* Check rugs and carpets for slippage or places somebody could trip.
* Consider the use of a hip protector – a low profile pad that you use beneath your clothing and over your hip to help absorb any impact from a fall.
* Keep cords stowed safely away.
* Place used items in easy to reach places – avoid step stools and ladders where balance might be lost.
* Make sure areas of the home and yard are well lit. Being able to see a danger is half the battle.
* use functional shoes that are non-slip.
Maintaining a healthy lifestyle can also decline your risk of breaking a hip. Not only exercise, but proper nutrition is important.
* Weight Bearing Exercise – Helps to fight bone density loss and works to continue the strength of tendons and muscles that sustain the joints. Not only that, but regularly walking or exercising will help to continue your sense of balance and agility – making the likelihood of a fall less likely.
* Smoking – Believe it or not, smoking truly works to reduce your bone density. So not only can it cause cancer – but it can weaken your bones.
* Calcium and Vitamin D – Proper nutrition and watching levels of calcium in your diet (by foods or supplements) will work to continue your bone density so that in the event of a fall, you are less likely to fracture your hip. Vitamin D is also a meaningful part of this course of action as it helps your body absorb and course of action calcium.
Other Hip Fracture Resources
There are a ton of obtainable resources on the web these days that can help you in the prevention of or recovery from a hip fracture. The following is a listing and review of some great web sites and articles if you would like more information on hip fracture prevention, treatment, and recovery.
The Mayo Clinic
The Mayo Clinic is a highly respected non-profit organization and clinic that maintains clinics in Minnesota, Arizona, and Florida. They also have a very informative web site that is a great resource for countless medical conditions. The section of the web site on hip fractures is very in thoroughness and organized in a way that you can find information very easily on prevention of hip fractures or help with recovery from hip surgery.
Care.com is an interesting web site in that it deals with the care of patients following surgeries like total hip substitute. On this web site you’ll find questions and tips related to helping patients or parents who are going by a difficult hip surgery recovery.
Advice on how to deal with the medical condition is provided, in addition as advice on how to help the patient mentally get by the recovery is discussed.
This web site also provides access to a network of caregivers and service providers in your area if you need additional help with recovering from hip surgery. You can find providers for any level of help that might be needed, from complete time care to part time help with housework and chores. The great thing about this service is that you can post your needs and interview possible caregivers in addition as look at a background check.
Maintaining an active and healthy lifestyle are the best preventative measures that you can take towards avoiding a hip fracture. Working as an online community and resource, EveryDayHealth.com is a great resource and web site to use to continue that active and healthy lifestyle.
Nutrition information and tools like their ‘meal planner’ and ‘weight tracker’ are great ways to make sure you are doing everything you can to stay healthy. Participating in the community forums is also a great way to meet other people facing the same issues or working towards the same goals.
Hip fractures are a shared injury, especially among the elderly – so reaching out to a community like EveryDayHealth will give you the opportunity to find understanding sustain of what it is you might be going by following hip surgery.
Finding the proper sustain, medical care, and tools to aid in the recovery from hip fracture surgery is a meaningful part to reducing the difficulty and likelihood of complications from a broken hip. Whether you have experienced a hip fracture or are just interested in the prevention of a future injury – there’s a myriad of online resources obtainable to help you in that quest.