Hip Fracture

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Last Medical Review: March 28, 2020
Medically Reviewed by Dr. David Costa Navarro

A hip fracture means that you have broken or suffered a crack in the skeleton of the femoral neck or upper part of the femur. It is almost always because you have fallen over.

The risk of breaking the hip joint increases the older you get, due to poor vision and balance while the skeleton becomes brittle. It is therefore good if you try to prevent cases by training your balance and adjusting the home.

Many who suffer a hip fracture are largely recovered. How good you are depends on what the offense looks like, your own health and fitness before the injury.

Symptoms

You may have the following symptoms if you fall and have a hip fracture:

  • You get a lot of pain in the groin or radiating pain in the thigh down to the knee.
  • You will have difficulty getting up because of the pain. You get more pain when you move or support your leg.
  • The leg is often twisted outwards and looks shorter.

Sometimes the case only leads to a crack in the femur or femoral neck. You can stand up and walk, but it hurts your hip. When you continue to strain the leg, it can cause it to go off completely. Then it hurts a lot and you can no longer walk.

When and where should I seek care?

If you suspect that you have had a hip fracture, contact a health care center or an on-call reception immediately.

Seek care at an emergency room if it is closed at the health center or on-call reception.

Call 911 if you or anyone else has injured your hip and can’t stand up and support your leg.

How can I protect myself from a hip fracture?

There are several ways to prevent hip fracture. For example, you can work out your balance and try to customize your home so the risk of falls decreases.

Exercise and the right diet provide stronger skeletons

You can reduce the risk of fracture by trying to keep the skeleton strong throughout your life. You lay the groundwork for a durable skeleton by eating good food and exercising regularly.

The structure of the skeleton requires, among other things, calcium and vitamin D. Calcium is especially important for young people and the elderly. A regular diet with milk products provides enough calcium, but older people may sometimes need supplements. Vitamin D is naturally formed in the skin when you are out in daylight. You may need to supplement with vitamin D if you are only staying indoors.

Children build the skeleton by moving and using their legs. Elderly people reduce the loss of bone mass and prevent osteoporosis by moving. A walk or other physical activity for a while every day prevents a skeletal skeleton, and you also exercise both muscle and balance. However, if you smoke, drink too much alcohol and do not touch you, you will get a brittle skeleton.

As you get older, the balance often deteriorates. Then it is good to try to prevent cases. A physiotherapist at the health center can help you with a workout program with balance exercises and a occupational therapist can help you with advice to adjust your home.

Reduce the risks at home

You can prevent hip joint fractures by adapting the home with, for example, good lighting, inserting slip protectors under the carpets and avoiding any cords or other objects that you can easily stomp on. It’s also good to have a modern phone that you carry with you, so you don’t have to rush to answer. You should avoid climbing on unstable pallets or chairs.

Higher doses of sleep and sedative tablets can help you feel unsteady and increase your risk of falling, especially at night. You should discuss with your doctor if you are taking medicines and feel dizzy.

There are special hip protection pants that can help if you are dizzy or easy to fall. They cushion the shock in cases. You can get help from a physiotherapist or occupational therapist to try out and order hip protection pants.

You may need to contact a doctor or optician if you are ill.

Medicines can help sometimes

Most often, osteoporosis, osteoporosis, is detected only when you have a bone fracture or a bone fracture. It can occur even in minor accidents as the skeleton is fragile. There are various drugs that you can get that counteract osteoporosis. The risk of osteoporosis increases with age and therefore it is primarily the elderly who receive treatment with drugs. However, it is good to know that just over half of everyone who gets a hip fracture has a fragile skeleton.

Surveys

You may undergo an X-ray examination to determine the injury. If the crime is not initially visible, a magnetic camera examination, or sometimes a computed tomography, is performed. More rarely, the X-ray examination needs to be repeated after a few days.

Treatment

Almost all hip fractures are operated.

The doctor strives to do the surgery within a day, but it is important that you feel as good as possible before the operation. Therefore, it may sometimes take longer before you can be operated on. It is often difficult for the hospital to determine exactly when the operation will be discharged, but efforts are made within 24 hours. You may sometimes need to get painkillers and drips while waiting for the surgery.

You must not eat, drink or smoke and drink for at least six hours before surgery.

You get help with showering and washing with a special bactericidal soap before surgery. You may also change into hospital clothes and lie down in a bed before driving into the operating ward.

Back anesthesia is more gentle

You usually get a back anesthetic and something soothing for the operation, but sometimes you may need to be anesthetized. Some may find it uncomfortable to listen to the sounds in the operating room and may then receive a sleep aid that allows you to sleep through the entire operation without being deeply asleep. Other people prefer to be awake and listen to music or radio in the headphones that are in the operating room.

There are various ways to operate a hip joint. The method used depends on what type of crime it is, how it looks and how strong the leg is. The operation team’s experience and differences between different hospitals and county councils can also guide the choice of method.

Fracture of the femur

If you have a crack or fracture of the femoral neck where the leg ends are in good position, the doctor usually attaches the leg together with two screws or nails. The location of the fracture and the position of the screws or nails are checked by means of an X-ray apparatus, which is connected to a monitor in the operating room. The operation team then follows the operation via the monitor. The operation usually takes up to 30 minutes.

You can get a new hip joint

If, on the other hand, you have a fracture of the femur neck where the bone fracture transmitters do not have good conditions to heal, screws or nails are not a good surgical method. This is because the blood circulation to the joint head is damaged when the ends of the fracture break apart. Usually you get an artificial joint, a hip prosthesis.

Depending on your age, other illnesses and the ability to recover, either the entire joint can be replaced with a prosthesis or only the femur and joint head can be replaced with a so-called half-prosthesis. A prosthetic surgery usually takes between one to two hours.

Fracture through the upper part of the femur

When the fracture passes through the upper part of the femur, where the muscles have their attachment, there are essentially two methods that the orthopedist can use.

One is that the doctor attaches a screw that goes up through the femoral neck into the joint head, which is then allowed to slide over a sleeve plate that is attached to the femur below the fracture.

The second method involves the doctor inserting a nail into the upper part of the femur and then the fracture is stabilized with one or two screws through the nail into the femoral neck and the articulated head.

Whichever method is used, the operation usually takes between half an hour to an hour.

Exercise after surgery

The training begins the same day or the day after the surgery. You may first go with the support of a so-called walkway and later with other aids, such as walker, crutches or crutches. You can also try to go down stairs before printing, usually after five to seven days.

It is possible to borrow crutches and other tools. Quite soon a crutch is enough to hold in the hand of the healthy side. A sockshopper is yet another easy tool that facilitates many newly operated.

Help at home

If you need domestic help to cope with daily life, the hospital will arrange it before leaving home. Persons who cannot manage at home immediately after the hospital stay may need a shorter period in a rehabilitation ward or in a municipal short-term residence.

Once at home, a occupational therapist, physiotherapist or nurse from the health care center or home health care contact and hear how it goes after the operation.

What is hip fracture?

The bone in the hip can mainly be broken in two different places. The fracture goes either through the actual femoral neck, which sits at the top of the femur below the articulation, called cervical fracture, or through the upper part of the femur where the muscles have their attachment, so-called thoracic fracture. Both types are equally common.

What is due to hip fracture?

When you are older, the risk of falling and having a hip fracture increases. You may just stumble or slip on the floor at home. This is because you often have worse balance and look worse, while the skeleton is often brittle.

The balance deteriorates as you get older. But in addition, the balance of various drugs, especially drugs for anxiety, sleep problems, depression and delusions, is deteriorating. Some blood pressure lowering drugs may also cause you to get a little worse balance.

The skeleton is reshaped throughout life. The bone tissue in the body breaks down and builds up. As you age, the skeleton becomes brittle as the build-up of the bones decreases as the decomposition continues. The amount of bone tissue decreases and thus the strength of the bone.

Common among older women

Each year, about 18,000 people are treated for hip fractures in Sweden. The average age at hip fracture is 82 years. Three quarters are women. This is because women have skeletal skeletons and, on average, live four years longer than men.

Many get well but it can take time

Many who have had a hip fracture are virtually restored, but not all. Some inconvenience may remain.

The healing time is long. How long it takes before the fracture heals depends primarily on whether the femur neck or upper femur is damaged. A fracture of the femoral neck usually takes longer to heal. You can count up to a year before you are restored. A fracture of the upper femur usually heals within three to six months.

How good you are depends on the severity of the crime and your own health and fitness before the injury. Some can train so they are fully restored, while others do not fully recover. You may need to be re-operated if the injury does not heal properly.

If you have a hard time moving before you broke your hip, it can be difficult to get really good afterwards. It is easy for muscles to become weak and lead to stiffness if you do not move very much. It is therefore important that you try to keep up as well as possible during the time the crime heals.

Complications

There are several complications that can occur after a hip fracture.

The health care staff will help you the day after the surgery so you can get up and stand on your legs. By being on your feet early, you reduce the risk of, for example, blood clots, pressure ulcers and many other complications.

You can get a blood clot

All operations involve an increased risk of blood clots. To reduce the risk, you will be given a preventative medication before surgery, and daily for a period afterwards. You can also prevent blood clots by quickly getting on your legs and moving after surgery.

You can still get a blood clot in the lower leg despite preventive measures. The leg then swells up and hurts. The blood clot usually arrives within the next few weeks after surgery and may be difficult to distinguish from the swelling that may occur if you do not move after the operation.

The usual swelling usually increases and decreases clearly during the day, and you notice the most forward evening. You should immediately contact a health care center or hospital if the swelling does not decrease and you suspect you have a blood clot.

You may get an infection

You are given antibiotics as protection in connection with the operation to reduce the risk of an infection after the hip joint surgery. The risk of infection then becomes very low.

There may be signs of an infection if the surgical wound wicks off and it turns red around the wound. You can also get a fever and it can hurt when you move. You should always contact a health care center or hospital if you have such symptoms.

Pressure Damage

You can get pressure damage in exposed places like the heels and the tail because you are still too much. You can avoid this by getting started and moving as soon as possible. You can also use relief pillows and special mattresses.

How is life affected by a hip fracture?

How life is affected by a hip fracture depends, among other things, on how you felt before the crime, what the crime looked like and what surgery was performed. Some hip fractures take longer to heal than others and this is partly due to how hard you hit yourself when you got the injury and how broken the skeleton was.

After a fracture of the femur, one is often quick on the legs, but the healing is slow. You are usually discharged from the hospital after about a week. Usually you need special tools to last for months. You can expect rehabilitation to take up to a year. You must be prepared for the leg to be slightly shorter regardless of the type of hip joint fracture.

The screws or nails can irritate the skin, making it difficult to lie on the operated side. Once the fracture has healed, the screws can be removed if irritated.

You should contact a health care center if you experience any complications or problems during the healing period. The health center will contact an orthopedic surgeon if needed.

Influence and participate in your care

You can seek care at any health center or open specialist clinic you want throughout the country.

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff.

You have the opportunity to get help from an interpreter if you do not speak English. You also have the opportunity to get help from an interpreter if you have a hearing loss.

If you need tools, you should get information about what is available and how to get it.

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