Hip Fractures

Most hip fractures result from a traumatic event which places unusual impact on the hip bone, such as a fall or a vehicle crash.

Especially in older people who have bone-weakening conditions like osteoporosis, hip fractures can be caused by twisting or pivoting suddenly. Severe osteoporosis may cause hip fractures during normal activities, such as walking or standing up from a chair.

Though less common, some hip fractures are sports injuries. These tend to be stress fractures and develop in long-distance runners or in military recruits during basic training, though some result from improper landings or tackles in high-impact sports.

Other factors can increase your risk of developing hip fractures. These include:

·      Age – bone density and muscle strength can decrease with age, making you more vulnerable to fractures

·      Gender – women have higher risks of hip fractures, especially after menopause.

·      Level of activity – regular activity promotes bone and muscle strength.

·      Medical conditions – conditions like Parkinson’s can reduce your balance, and some thyroid disorders or osteoporosis reduce your bone strength.

·      Medications – many drugs that improve sleep can reduce your balance and increase your risk of falls, while others can affect your bones’ ability to heal from injuries.

In most cases, your hip injury will be assessed by a doctor in a hospital emergency department. The doctor will ask you questions about how the injury happened, your pain levels, and if you have any other physical or mental health conditions. They may also inspect your hip and ask you to try and move it in certain ways.

If they suspect a hip fracture, they will usually order imaging tests to confirm it. These may include:

·      X-rays – these imaging tests let doctors see any abnormalities in the hip’s shape or structure. Most hip fractures can be diagnosed with x-rays.

·      MRI scans – using magnetic imaging instead of x-rays, MRIs can detect some hip fractures that are too fine to be seen on x-rays. They can also show damage to the soft tissues and other structures in your hip.

·      CT scans – CT scans use more powerful x-rays to create cross-section images of your hip bones. Your doctor may request a hip CT scan to learn more about the fracture.

Most hip fractures are treated with surgery in some form, though your orthopaedic surgeon may recommend different approaches depending on the nature of your injury. If you get admitted to the hospital with a hip fracture, your medical team will aim to operate within 48 hours.

Your exact treatment options will depend on the severity and location of your fracture, your age, your lifestyle needs, and your overall bone health. Under guidance from your surgeon at Orthopaedics SA, your treatment options for a hip fracture may include:

·      Internal fixation – if your fracture is not large or significantly displaced, your orthopaedic surgeon may place metal screws, pins, or rods in your hip to hold the bones in place as they heal.

·      Partial hip replacement surgery (hemiarthroplasty) – about 50% of all hip fracture cases need some form of hip replacement, whether partial or total. If your fracture is inside the hip socket, your surgeon may recommend replacing the top part of your thigh bone which connects to your hip socket with a prosthetic part.

·      Total hip replacement surgery – more severe fractures or fractures in people with active lifestyles may require a total hip replacement. They are particularly recommended if your hip bone has poor blood supply and may not heal the fracture fully.

It’s often said that the best treatment is prevention.

·      Get enough calcium and vitamin D – these two nutrients promote bone strength, making your hip less likely to fracture in the event of a fall.

·      Manage osteoporosis – if you suffer from osteoporosis, your doctor may recommend bisphosphonate medications that slow bone loss. This helps keep your bones strong and makes them less susceptible to fractures.

·      Stay active – weight-bearing exercises help maintain bone density and keep you healthy overall. Regular activity can also improve your sense of balance and muscle strength, preventing falls.

·      Avoid tobacco and alcohol use – as well as reducing your bone density and making you more susceptible to fractures, using too much of either can make you dizzy and increase your risk of falls.

·      Keep your home free from trip hazards – loose rugs, cables, and excess furniture can cause you to trip and fall. Ensuring that your house is well-lit can also help prevent falling at home.

·      Check your eye health – being unable to spot hazards increases your risk of falling and developing a hip fracture significantly.

·      Use walking aids if needed – a cane or walker may prevent falls by helping you balance, or may help reduce impact on a painful hip. Talk to your doctor about finding the right walking aid for you.

·      Wear a hip protector – These are made of padded material and plastic shields which attach to specifically designed underwear. When worn under the clothes, they can absorb the shock from a fall and divert the impact away from vulnerable areas.

·      Use the FRAX tool – Developed by the World Health Organisation, FRAX is a risk assessment tool that helps predict the likelihood of fractures in people aged 40-90. You can learn more about it here.