Introduction to Hip Fractures
Hip fractures are becoming more common as our population ages. Females have twice the risk of a hip fracture compared to men. Currently, huge research projects are trying to establish clinical standards and pathways so people who are at risk for hip fractures are treated prior to them breaking their hips. The best treatment for a hip fracture is preventing it from happening. As orthopaedists continue to address this concern, primary care doctors have started initiating osteoporosis workups into their annual checkup. If you haven't yet, the first step in prevention is looking for osteoporosis (thinning of the bones) and starting treatment.
Help, I've fallen and I can't get up
As our population gets older, more of us remember that commercial about not being able to get up after a fall. As a larger percentage of our population ages, more hip fractures are predicted to occur in the coming years. Most commonly, hip fractures occur in the elderly when they have a slip and fall. It may be as simple as losing balance while walking or falling in the shower. Breaking your hip is an overall picture of your overall body health. The energy required to break a hip is significant and if a fall from standing enough force to break your hip, then it probably means your bones have become weak due to age and osteoporosis.
Types of Hip Fractures
Depending on how the hip is broken, there are three different possible procedures that can be performed. Below are pictures with fixation methods and for what pattern they are used for.
A percutaneous pinning is a procedure performed when there is a nondisplaced or minimally displaced femoral neck fracture. This procedure involves a small incision on the outside of the leg and is minimally invasive. Patients may ambulate the day of surgery.
Partial or Full Hip Replacement
A partial (hemiarthroplasty) hip replacement is a very commonly procedure performed for hip fractures that are severely displaced. These fractures will not heal if treated with other techniques. In this procedure, an incision is made, an anterior approach is taken to the hip and the broken ball is removed and replaced with a stem with a new ball.
Intramedullary nailing describes placing a rod into the thigh (leg) bone and then a screw into the center of the hip (ball). By doing this, we restore immediate stability and encourage immediate ambulation. The procedure is performed through a minimally invasive incision and is an excellent way to help those with intertrochanteric hip fractures.
Post Operative Rehabilitation
After a hip fracture, emphasis will be on rehabilitation. While in the hospital, you can expect therapy 1-2 times per day where the patient will be able to walk right away. Our care team will ask where the hip fracture patient lives, how much support they have at home, if they have steps at home and their level of independence prior to the injury. All of these factors will be brought up to physical therapy, case managers and social workers and the surgeon who fixed your hip. Together, using a team based approach, we determine the best placement for you after your surgery. Patients typically will go to a rehabilitation facility after their hip fracture where they can get 24/7 care as well as daily therapy to help improve their outcome.