A hip fracture is 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 a hip fracture is primarily based on the bones and soft tissues affected or on the level of the fracture.
Older people are at higher risk of hip fracture because bones tend to weaken with age. This bone weakening is called osteoporosis. Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.
How do hip fractures happen?
Hip fractures in the elderly are most often caused by a fall, usually a seemingly insignificant fall. In younger patients with stronger bones, more common causes of a broken hip include high-energy injuries such as car accidents. Hip fractures can also be caused by bone weakened from tumor or infection, a problem called a pathologic fracture.
A broken hip in the elderly can be explained primarily by weak bones and osteoporosis. Elderly patients with osteoporosis are at much higher risk of developing a hip fracture than someone without osteoporosis. Other risk factors associated with hip fracture are female sex, Caucasian race, slightly built individuals, and limited physical activity.
Who is at risk?
- Women sustain three-quarters of all hip fractures.
- White women are much more likely to sustain hip fractures than are African-American or Asian women.
- In both men and women, hip fracture rates increase exponentially with age.13 People 85 and older are 10 to 15 times more likely to sustain hip fractures than are those age 60 to 65.
- Osteoporosis, a disease that makes bones porous, increases a person’s risk of sustaining a hip fracture.
- The National Osteoporosis Foundation estimates that more than 10 million people over age 50 in the U.S. have osteoporosis and another 34 million are at risk for the disease.
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).
How is a hip fracture treated?
Most people who have hip fractures will need surgery to make sure the leg heals properly. Your doctor will discuss your surgery options with you.
Some people are unable to have hip surgery because of an illness or poor health. If your doctor doesn’t think it’s safe for you to have surgery, you will be put into traction to help your hip heal. Traction keeps you immobile for a long period of time.
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