Over 300,000 people a year are hospitalized for a hip fracture, almost all of them adults over the age of 65. Because older adults are more likely to fall and generally have weaker bones than their younger counterparts, their risk of incurring a hip fracture is quite high.
Due to the nature of this injury as well, mobility challenges and even fatality can be the end result. Reports from the Mayo Clinic have even found that over half of all hip fracture patients are unable to regain their ability to live independently.
Understanding how and why hip fractures happen can improve longevity for seniors and equip them and their caregivers with the knowledge and tools to prevent these potentially fatal injuries.
How do Hip Fractures Happen and What Are the Symptoms?
Typically a severe impact or blow is responsible for causing a hip bone to fracture, however, doctors have seen fractures in older adults, especially those with low bone density, who have simply stood on one leg and twisted their bodies. A severe impact will occur with something like a car accident or falling to the ground (most often from a standing position).
The hip joint is what is known as a ball-and-socket joint; the head of the femur (thighbone) rests in the acetabulum (socket of the pelvis) which allows the upper leg to bend and rotate. The three most common hip fractures are:
Intracapsular fracture – a fracture in the head of the femur (typically within the soft tissue capsule that envelopes the bone with nourishing and lubricating fluid)
Intertrochanteric fracture – a fracture further down the bone between the neck of the femur and the lesser trochanter, a bony prominence around the hip
Subtrochanteric fracture – a fracture that occurs even further down below the lesser trochanter (this type of fracture may involve several pieces of broken bone)
You are at increased risk for hip fractures if you are more prone to falling (due to age or medical condition) and if you lack sufficient bone density. There are many reasons your bones may not as strong as they should be including:
Sex – following menopause, women lose bone density at much higher rates than men
Malnutrition – if your body is lacking certain nutrients and minerals like vitamin D and calcium, your bones don’t have the building blocks they need to sustain mass
Chronic illness – some intestinal and endocrine disorders can specifically affect your body’s ability to build bone mass
Tobacco and alcohol use – smoking and excessive drinking may contribute to poor bone density
Lack of exercise – inactivity, especially not partaking in weight-bearing exercises, can result in weak bones and muscles
If a hip gets fractured in a fall, you’ll most likely feel immediate pain or discomfort. Swelling, stiffness, and even a visibly deformed hip area may also be present. Pain will often radiate in the groin area if you try and bear weight, though weakness and discomfort may prevent you from standing, bending, or twisting your leg at all.
Interestingly, for people who are already immobile or bed-limited, a hip fracture may not present any significant symptoms so it is important for caregivers to mindfully check for pain or swelling following a fall.
Treatment and Recovery
In most cases, prompt surgical intervention is required to repair a hip fracture. Treating medical professionals do have to weigh the risks of surgery for much older patients and seniors with complicated medical conditions, however, as going under general anesthesia and receiving a major surgery like hip repair can itself be life-threatening.
Imaging tests are done prior to surgery to confirm the type and location of the fracture, and occasionally other diagnostic tests, like urinalyses and cardiac exams, will be administered to ensure the health of the patient and prevent unwanted complications, like infections.
Complications from undergoing a major surgery for a mobility-limiting injury may include respiratory infections, pressure ulcers, urinary tract infections, and blood clots. It is critical that patients seek immediate rehabilitation, either at a dedicated facility or at home, and start working towards regaining their ability to walk.
Rehabilitation and Exercise
The primary goal of recovery following surgery to repair a hip fracture is to remobilize the joint. Hip fracture patients will work with their doctor and a physical therapy and rehabilitation team to get back on their feet and start walking and exercising again, both improving joint range of motion as well as building muscle back up in their legs.
Assistive Tools and Devices
Lift chairs are recommended for recovery as they simplify the process of lying down, sitting, and then rising up into a standing position. Additional mobility aids like rollators empower hip fracture patients to get up and moving, and ease-of-use tools like reacher grabbers, shower transfer chairs, and toilet seat risers can aid with activities of daily living.
Over-the-counter pain medicine and anti-inflammatories may be recommended for treating acute pain following surgery. In some cases, a physician may also prescribe opioid painkillers, though they can be highly addictive and lead to side effects that worsen a patient’s state.
Sometimes patients will also do a round of antibiotics after surgery to prevent infection as well as blood thinners to prevent the formation of blood clots.