Understanding Hip Fractures: What Are The Different Types Of Hip Fractures?

A hip fracture or a hip bone fracture is a partial or full break of the femur (thigh bone) at the point where it meets the pelvic bone. It's a critical injury that has to be treated right away. People over 60 account for the majority of hip fracture cases, typically in people whose bones have been weakened by osteoporosis. In younger people, fractured hips are most commonly caused by vehicle accidents, long falls, or other serious injuries. Almost all hip fractures require surgery and physical therapy. The recovery might take up to a year.

What Are The Different Types Of Hip Fractures?

The location of the break and the type of bone break are used to categorise hip fractures. Hip bone fractures are classified into three categories, each with its own set of consequences.

• Intracapsular fracture
• Intertrochanteric fracture
• Subtrochanteric fractures

Hip fractures of the intracapsular and intertrochanteric kinds account for about 90% of cases. The treatment approach for a hip fracture is primarily determined by the specific type of fracture.

Intracapsular Fractures

Fractures in the intracapsular region of the hip can affect both the femoral head and neck since this region includes both of these structures. Femoral neck fractures are more common because the femoral neck is more susceptible to impact compared to the femoral head. These fractures typically occur approximately one to two inches below the hip joint. They are often associated with osteoporosis and are commonly seen in elderly individuals. This type of fracture can lead to complications as it disrupts the blood supply to the head of the femur at the hip joint.

Subtrochanteric Fractures

Subtrochanteric fractures are fractures that occur in the upper section of the femur shaft, just below the hip joint. The femur bone can fracture at any point along its length, extending from the hip socket to the top of the knee. Subtrochanteric fractures can range from clean breaks to compound fractures. The severity of the fracture can be evaluated through imaging techniques such as X-ray or MRI scans.

Intertrochanteric Fractures

An intertrochanteric hip fracture occurs approximately three to four inches below the hip joint. In some cases, intertrochanteric fractures can be compound fractures with shattered bone fragments. The fracture line can extend from the lesser trochanter to the greater trochanter or may have additional breaks along this line. Compared to certain other types of hip fractures, intertrochanteric fractures are generally considered easier to fix and do not typically disrupt the blood supply to the bone.

What Are The Symptoms Of A Hip Fracture?

Symptoms of hip fracture might vary from patient to patient but typically include:

• Inability to walk or put any weight on the leg
• Bruising or swelling at the hip
• Extreme pain in the hip and groin area
• Shorter leg on the affected hip's side
• The foot turned outwards on the side of the injured hip

A hip bone fracture typically causes severe pain, and even partial weight-bearing on the leg can be excruciatingly painful.

What Causes Hip Fractures?

Most hip fractures occur in elderly individuals with weakened bones, while serious trauma can cause hip bone fractures in people of all ages. Stress fractures or repeated trauma can affect the femoral neck, commonly observed in runners and military recruits. Fractures of the femoral head are rare and usually associated with high-impact accidents or hip dislocations. Other factors that increase the risk of hip injury are:

• Gender:Women are three times more likely to sufferhip fracturesthan men.
• Family history
• Physical inactivity
• Weak bones due to calcium and Vitamin D deficiency.
• Medical conditions like osteoporosis, arthritis, or balance issues.
• Smoking habit
• Long-term medication that can weaken bones

Hip Fracture Medication

Medications are commonly used in the management of hip fractures for pain control, to prevent blood clots, and to support bone health. Medication choices may vary depending on individual patient factors and physician recommendations.

How Are Medicines Effective For Hip Fractures?

Pain relievers alleviate discomfort, anticoagulants reduce the risk of blood clots, and calcium/vitamin D supplements aid in bone healing. Medications are prescribed based on individual needs to improve outcomes and facilitate recovery.

How Is A Hip Fracture Treated?

Hip fractures are typically treated through surgery, aiming to stabilize the fracture and restore mobility. The specific surgical procedure depends on factors like the type and location of the fracture. Common techniques include internal fixation using screws, plates, or rods or hip replacement surgery for more complex fractures. After hip fracture surgery, physical therapy plays a crucial role in rehabilitation. It helps improve strength, mobility, and balance, aiding in the recovery process.Pain management,medication, and preventive measures against complications like blood clots are also integral to the treatment.

What Is The Surgical Treatment For Hip Fractures?

Depending on the location and severity of the break, there are two types of hip fracture surgery.

1. Hip repair surgery, also known as "hip pinning" or internal fixation, involves using metal rods, screws, or plates to hold the fractured bone together while it heals. This procedure is suitable when the bones can be properly aligned.
2. Hip Replacement Surgeryinvolves replacing part or the entire hip joint with prosthetic components. In a partial hip replacement, only the fractured upper portion of the thigh bone is replaced. In a total hip replacement, both the hip socket and the top of the thigh bone are replaced. Total hip replacement is typically performed when the broken bones cannot be properly aligned.

What Is The Non-Surgical Treatment For Hip Fractures?

If the bone fragments remain in proper alignment, the following non-invasive techniques may be considered for the treatment of hip fractures: Activity Modification: Avoiding weight on the injured site by using crutches, a walker, or a cane for approximately 6 weeks can allow the bone to heal. Electronic and Ultrasonic Bone Stimulation: Low-electric current or low-intensity pulsed sound waves can be utilized to promote faster bone healing. Physical Therapy: Exercises such as leg lifts and hamstring stretches are recommended to maintain mobility and strengthen the muscles and joints around the affected area. It is important to consult a doctor or specialist to determine whether an operation or non-surgical procedure is the most appropriate course of action.

How Painful Is A Fractured Hip?

A broken hip is a painful injury that impairs mobility. Hip stress fractures can cause groin pain while standing or moving, making activities like walking, running, and climbing stairs agonizing. Chronic hip pain can lead to long-term effects such as dementia, depression, and disturbed sleep and hinder the management of other health issues. Pain also hampers physical treatment and rehabilitation.

Why Is A Hip Fracture So Dangerous For The Elderly?

A hip fracture is dangerous for the elderly due to the need for surgery to regain mobility and manage pain. Elderly patients face additional post-operative risks such as infections, blood clots, bedsores, urinary tract infections, and pneumonia. Longer recovery time increases the risk of muscle loss and subsequent falls. Older patients are more at risk for several reasons, including:

Lower Bone Density

Bone density is relatively lower in the 60-plus age group. Hip fractures in elderly people are more likely due to common disorders like osteoporosis, which makes bones brittle and weak.

Pre-Existing Medical Conditions

Pre-existing medical conditions significantly contribute to the danger of hip fractures in the elderly. Conditions like osteoporosis (reduced bone density), osteoarthritis (joint degeneration),rheumatoid arthritis(chronic inflammatory joint disease), Parkinson's disease (movement disorder), and certain endocrine disorders (e.g., hyperthyroidism, Cushing's syndrome) weaken bones and impair mobility and balance, making seniors more susceptible to fractures. These conditions complicate rehabilitation and increase the risk of complications and further falls.

What Is The Prognosis For Hip Fracture Patients?

The prognosis for hip fracture patients can be challenging. Elderly individuals may experience reduced mobility, relying on assistive devices like canes or walkers. The prognosis depends on factors such as:

1. Age:Older individuals may experience slower healing and potential limitations for surgery, leading to prolonged bed rest and associated complications.
2. Health:Those who can begin moving shortly afterhip fracture surgerytend to have a better prognosis, as movement accelerates the healing process and reduces the risk of complications from extended bed rest.
3. Fracture Type:Femoral neck fractures can result in a compromised blood supply to the femoral head, leading to bone deterioration and osteonecrosis. Additionally, the presence of additional tissue injuries can slow down the healing process.

Read This Blog For More Details:Hip Fractures & Replacement Surgery

Frequently Asked Questions

1) What Is The Most Significant Complication After A Hip Fracture?

Infections in the chest and wounds are the most frequent post-surgery complications experienced after a hip fracture.

2) Which Part Of The Hip Is Most Commonly Fractured?

The two most typical kinds ofhip bone fracturesare femoral neck and intertrochanteric fractures.The femoral neck is the region of the femur connecting the femoral head (ball) to the shaft of the femur.

3) What Is The Recovery Time For A Hip Fracture?

Recovery time after hip fracture surgery varies based on the type of surgery, mobility, age, and overall health. With physical therapy and appropriate measures, most individuals regain mobility within 6-9 months.

4) Can Hip Fractures Be Prevented?

Yes. Hip fractures can be prevented by engaging in regular weight-bearing exercises such as walking, jogging, or hiking. Additionally, regular screening and maintenance of bone strength, along with strengthening muscles, can help reduce the risk of hip fractures.