About Hip Fractures
The most common symptom of a hip fracture is pain. This is usually located in the groin, sometimes radiating down the front of the thigh towards the knee, and also occasionally felt in the buttock area. Hip fracture patients have a hard time with almost any movement of the hip area or thigh and are usually unable to put any significant weight on the leg.
Cause and Anatomy of a Hip Fracture
Most hip fractures result from low energy falls from standing height in elderly patients with weakened bone. Hip fractures in younger patients with normal bone quality are rarer and the result of higher energy injuries such as falls from height, motor vehicle collisions, and motorcycle accidents. Hip fractures can also present as stress fractures in very active young individuals such as runners and military recruits. Some osteoporosis medications can predispose older patients to a certain type of stress fracture in the hip area.
Hip fractures involve the upper-most part of the femur bone. The ball of the hip joint is the top of the femur and is called the femoral head. Just below this is a narrow area called the femoral neck. As you move further down from the hip joint the femur widens and has protuberances called the greater and lesser trochanters. This region is called the intertrochanteric region. The next area down, where the femur narrows down towards the thigh, is called the subtrochanteric region. Each of these areas of the upper femur can be involved in different types of hip fractures.
Diagnosis of a Hip Fracture
A patient with a hip fracture is often transported to a hospital emergency room where he or she is first seen. Often the affected leg will look shorter than the non-affected leg and will be rotated internally or externally. Sometimes there will be bruising on the side of the affected hip. Most fractures of the hip are diagnosed with x-rays. Hip fractures are referred to by the area of the femur bone that is affected: femoral neck fractures, intertrochanteric fractures, or subtrochanteric fractures.
What Are My Options?
Most hip fractures have significant movement of the broken ends at the time of injury, and those which are not displaced have a high risk of moving significantly without surgical treatment. Therefore, most hip fractures are treated with surgery to give patients the ability to stand and walk again on a healed femur. Exceptions to this would include patients ill enough that the risk of anesthesia is extreme or those who are wheelchair-bound and it is a patient and/or family decision to not undergo surgery.
The type of surgical treatment recommended depends on which area of the femur is fractured. Femoral neck fractures with little to no movement can be fixed with a few screws to stabilize the fracture and prevent displacement, keeping the patient’s original hip joint intact.
Frequently Asked Questions
Can or should the hardware be removed after a hip fracture is fixed?
Hip fixation hardware can stay in place for the remainder of a person’s life and cause absolutely no issues. If the hardware is deemed to be causing pain after a hip fracture has healed, it can be removed with a small surgical procedure with a short recovery.
How long does it take for a hip fracture to heal?
Most hip fractures have full bone healing in 3-4 months. Due to the time spent using crutches or a walker, however, patients have almost always lost some muscle mass in their buttock and thigh. The muscle-strengthening part of the recovery can take an additional 3-4 months after bone healing.