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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.
Hip Fracture
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Causes

A hip fracture is caused by a trauma to the bone. Fractures in young people with healthy bones are cause by major trauma. Fractures in older adults or people with conditions that lead to weakened bones may be caused by minor trauma.

Risk Factors

Factors that increase the risk of fracture in people with healthy bones include:
Women are more likely than men to fracture their hips, especially after menopause. It is more common in older adults. Other factors that increase the risk of hip fractures include:
Factors that can weaken bone and increase the risk of fractures include:
Factors that increase the risk of falls that can lead to fractures include:

Symptoms

A hip fracture may cause:

Diagnosis

You will be asked 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

Talk with your doctor about the best treatment plan for you. Options include:

Surgery

Surgery is needed for most hip fractures to make sure the hip heals properly. Surgery will also allow you to move about as you recover. However, surgery may not be appropriate for some people with small fractures or poor overall health. These fractures will be monitored as they heal with imaging tests. Traction may also be used to hold the leg in the appropriate place while the bone heals.
The type of surgery will depend on what part of the hip bone was broken, how severe the fracture was and the overall health of your bone. Surgical options include:
  • Insertion of surgical plates and screws to realign the bones and/or support the fractured area. The bone will be able to heal more securely.
  • Hip replacement—damaged areas of bone are removed and metal devices are inserted in their place. This surgery is reserved for those with severe bone injury or disease. It is more common in older adults.
Your doctor may recommend assistive devices such as wheelchair, cane, or walker for your recovery and rehabilitation.

Physical Therapy

A physical therapist will assess the hip fracture. An exercise program will be created to help recovery and to strengthen the muscles.

Prevention

Major trauma is typically caused by accidents and hard to avoid.
Talk to your doctor if you have osteoporosis or are at risk for osteoporosis. Medications, dietary changes, and weight bearing activities may help slow bone loss.
To reduce the risk of falls:

RESOURCES

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

OrthoInfo—American Academy of Orthopaedic Surgeons http://orthoinfo.org

CANADIAN RESOURCES

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

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

References

Hip fracture. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 30, 2015. Accessed February 11, 2016.

Hip fracture prevention. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00309. Updated January 2013. Accessed February 11, 2016.

Ly, Thuan V and Swiontkowski, Marc F Management of femoral neck fractures in young adults. Indian J Orthop. 2008 Jan-Mar; 42(1): 3–12.

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.

11/6/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Sennerby U, Melhus H, Gedeborg R, et al. Cardiovascular diseases and risk of hip fracture. JAMA. 2009;302(15):1666-1673.

1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: 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.

4/24/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Ward RJ, Weissman BN, et al. ACR Appropriateness Criteria for acute hip pain: suspected fracture. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/AcuteHipPainSuspectedFracture.pdf. Published 2013. Accessed February 11, 2016.

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