Types and Treatments of Hip Fracture | Physiotherapy

Hip Fracture

What is a hip fracture?

Hip fracture is a serious injury with fatal complications. The risk of hip fracture increases with age. A fracture is a partial or complete break in a bone. There can be either a single break or multiple breaks in a bone.

The risk increases as bones weaken with age (osteoporosis). Multiple medications, proper vision, and even balance problems can lead to falls in the elderly, one of the most common causes of hip fracture.

A hip fracture almost always requires surgical repair or restoration, followed by physical therapy. Taking steps to maintain bone density and prevent falls can help prevent hip fractures. Hip fracture is characterized by a specific area of ​​fracture and fracture in the bone.

Types of hip fracture

  • Femoral Neck Fracture: A femoral neck fracture occurs an inch or two from the hip joint. These fractures are common in the elderly and are associated with osteoporosis. This type of fracture can cause a problem because the break generally reduces the blood supply to the head of the thigh where the hip joint forms.
  • Intertrochanteric hip fracture: Intertrochanteric hip fracture occurs three to four inches from the hip joint. This type of fracture does not interfere with the blood supply to the bone and may be easier to repair.

About 90 per cent of hip fractures fall into these two categories in relatively equal numbers. Another type of fracture called a hip fracture and it is difficult to diagnose. It is a small crack in the bone that may not cover the entire bone. Excessive consumption and repetitive movements can cause stress cracking. The symptoms of this injury mimic the tension of the tendons or muscles.

Symptoms of hip fracture

Signs and symptoms of a hip fracture:

  • Inability to get up or walk after a fall.
  • Severe pain in the hips or groin.
  • Pain or swelling in the hip or groin
  • Obvious deformity or uneven leg length
  • Inability to stand or walk
  • Limited movement in the hip area; The external turn of the leg.
  • Injury (indicates damage to blood vessels)
  • Inability to put weight on the leg towards the injured hip
  • Injury and swelling in and around the hip area
  • Short leg towards injured hip
  • Rotate the leg outward toward the injured hip

Risk factors for hip fractures

The risk of fracture increases if you have:

  • Injury from a car crash, accident, sports injury, fall, or physical abuse
  • Low mineral content in your bones.
  • A genetic disorder that affects your bone metabolism and muscle mass.
  • Endocrine dysfunction
  • Poor nutrition and/or overweight
  • Lack of calcium in your diet.
  • Previous history of fracture (s)

Hip fractures in teens are usually caused by sports injuries. When the hip is broken, other structures that support the pelvic bones are also injured. These include:

The hip fracture rate increases significantly with:

  • Age: Bone density and muscle mass decrease with age. The elderly can also have vision and balance problems, increasing the risk of falls.
  • Your gender: Hip fractures are three times more common in women than in men. Women lose bone density faster than men because the decrease in estrogen levels caused by menopause accelerates bone loss. However, men tend to develop lower levels of bone density.
  • Osteoporosis: If you have this condition that can cause bones to weaken, you are at risk for fractures.
  • Other chronic medical conditions: Endocrine disorders, such as an overactive thyroid, can lead to brittle bones. Intestinal disorders, which reduce the absorption of vitamin D and calcium, which can lead to the weakening of the bones.

Medical conditions that affect the brain and nervous system, including cognitive decline, dementia, Parkinson’s disease, strokes, and peripheral neuropathy, also increase the risk of falls.

  • Having low blood sugar levels and low blood pressure also contributes to the risk of falling.
  • Some drugs: Cortisone medications, such as prednisone, can weaken your bones if you take them for a long time. Combinations of certain medications or certain actions can make you feel dizzy and dizzy. Medications that act on the central nervous system (sleeping pills, antipsychotics, and narcotics) are often associated with falls.
  • Nutritional problems: Lack of calcium and vitamin D in your diet during childhood can reduce your bone mass and increase your risk of fractures later in life. Getting enough calcium and vitamin D in old age is also important in trying to maintain the bone you have. At your age, try to maintain a healthy weight. Being underweight increases your risk of bone loss.
  • Physical inactivity: Lack of regular exercise with weights, such as walking, can weaken bones and muscles and lead to falls and fractures. A pressure fracture or an undisplaced fracture may not have an obvious deformity. However, most patients have some displacement of the fracture. As a result, when the patient is in the supine position, the leg is placed in external rotation and abduction and appears to be compressed. The pain comes with the rotation as a trunk roll manoeuvre, which involves gentle internal and external rotation of the lower leg and thigh. Also, a fracture may occur if the pain in the groin occurs when an axial load is applied to the affected limb. Due to pain and instability, patients cannot lift an active straight leg. Ecchymosis is very rare at first. Pulses and distant sensations should be evaluated and documented. Patients should be examined for additional related injuries.
  • Tobacco and alcohol: Both can interfere with the normal processes of building and maintaining bones, resulting in bone loss.

Prevention measures of hip fracture

Healthy lifestyle choices during adolescence can increase bone mass and reduce the risk of osteoporosis in later years. The same steps you take at any age can lower your risk of falling and improve your overall health.

To prevent falls and maintain healthy bones:

  • Exercise to strengthen your bones and improve balance. Weight-bearing exercises, such as walking, can help you increase bone density. Exercise also increases your overall strength, making you less likely to fall. Balance training is also important in reducing the risk of depression, as balance decreases with age.
  • Avoid smoking or excessive alcohol consumption. Tobacco and alcohol consumption reduces bone density. Drinking too much alcohol can damage your balance and make you more prone to falls.
  • Assess your home for accidents. Remove rugs, place electrical cords against the wall, and remove excess furniture and anything that could cause you to trip. Make sure all rooms and paths are well lit.
  • Check your eyes. Get an eye exam every year or more if you have diabetes or eye disease.
  • Take care of your medications. Feeling weak and dizzy, which are the side effects of many medications, increases your risk of falling. Talk to your doctor about the side effects of your secondary medications.
  • Get up slowly. Getting up too quickly lowers your blood pressure and makes you move.
  • Use a cane, cane, or walker. If you don’t feel stable while running, ask your doctor or occupational therapist if these aids can help.
  • It can be very difficult to prevent a child from breaking a bone, especially if he is very active and plays sports. The value of children’s participation in sports and games outweighs the risk of fractures.
  • Healthy diet: low in fat, high in protein, nutrients, and fibre.
  • Make sure you have enough calcium in your diet (milk, yogurt, cheese, fish, and vegetables are foods rich in calcium)
  • Control your parts to help you manage your weight, as balance puts you at higher risk for bone fractures.
  • Limit sodas and sugary snacks.
  • Have regular meal times and limit lunch between them
  • Encourage him to exercise with weights.
  • Avoid watching television, playing computer games, or other sedentary activities for long periods of time.

Treatment for hip fracture

You will need surgery to fix your hip. Surgery usually works well, but the hip takes a long time to heal.

Surgery is done as soon as possible after a hip fracture is diagnosed, often within 24 hours. Immediate surgery can shorten your hospital stay and reduce pain and complications. Sometimes surgery is delayed 1 to 2 days so other medical problems can be treated first. Most surgeons agree that patients would do better if they had surgery very quickly. However, it is important to ensure the safety of patients and maximize their overall medical health prior to surgery. This means taking the time to do cardiac and other diagnostic studies before surgery.

How can a hip fracture be treated without surgery?

Non-surgical patients may be anaesthetized and unable to walk prior to their injury and may be confined to a bed or wheelchair.

Some types of fractures are considered stable enough to operate without surgery. Since there is some risk that these “fixed” fractures will be unstable and shift (change in position), the doctor will need to follow up with periodic X-rays of that area. Although patients may be confined to bed rest as part of the treatment of these fractures, they may need to be closely monitored for problems with long-term stabilization. These include infections, bedsores, pneumonia, blood clots, and wasted nutrients.

How can a hip fracture be treated with surgery?

If the femur (“ball”) breaks by itself, the goal of maintenance is to fix the cartilage on the injured or displaced ball. Often with these injuries, the socket or acetabulum can also rupture. The surgeon must also consider this.

These injuries can approach from the front or back of the hip. In some cases, two procedures are required to clearly view and repair the injured bone. In the case of true intracapsular hip fractures, the surgeon may decide to repair the fracture with individual screws (percutaneous nailing) or with a single large screw that slides into a plate cylinder. This compression allows the fracture to become more stable by applying the effect of the fracture area to the hip screw. Occasionally, a secondary screw can be added for added stability.

In these cases, the blood supply to the ball, or the head of the bone, can be damaged during injury (avascular necrosis). Even if the fracture is detected and held stable, the cartilage and underlying auxiliary bone may not receive enough blood. For a time, this can cause the head of the thigh to flatten. When this happens, the surface of the joint becomes uneven. Eventually, despite surgical repair, the hip joint can develop painful arthritis.

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