The hip joint is a ball and socket joint where the femur head (ball) links the pelvic bone (socket). Hip fracture is break of the femur bone. About 90% of hip fractures occur in people above the age of 60. The risk for fracture multiples with increasing age due to osteoporosis. Osteoporosis is a natural degenerative condition that causes loss of bone tissue. There are two types of hip fractures:
Femur Neck Fracture – this occurs within the hip joint through the narrowest part of bone.
Intertrochanteric hip fracture – this occurs outside the hip joint through the broadest part of bone.
Hip fractures cause significant pain and loss of mobility necessitating admission to hospital. Reduced mobility can lead to pneumonia, urinary tract complications, constipation, bed sores clotting of blood in the leg veins, muscle atrophy from disuse and mental deterioration. Surgical fixation of the fracture offers the best chance of early return to limited mobility.
Femur Neck Fracture – Replacement of the ball with or without use of cement (open surgery)
Intertrochanteric Hip Fracture – Internal fixation by plate or nail (limited open surgery)
45 to 60 minutes
General anesthesia or regional (spinal) blockade.
04 to 05 days
Under cover of appropriate pain medication the patient is mobilized out of bed the day after surgery. Walker aided full weight bearing and ambulation around the bed is encouraged. Nutritional support is vital and along with exercises for general well-being under guidance of trained physiotherapists. It is strongly recommended to continue medication for existing ailments (hypertension, hypothyroid, asthma) under guidance of the physician.
Specific treatment depends on age, overall physical and mental health. On one hand prolonged bed rest is associated with serious complications and surgical fixation is also not risk-free. Despite surgery there is significant loss of independence, reduced quality of life and depression.