A hip fracture occurs when there is a break in the upper portion of the femur (thighbone) where it joins the pelvis.   The hip joint is a ball-and-socket joint where the ball is the head of the femur and the socket is called the acetabulum which is part of the pelvis bone. It has a round shape which allows the head of the femur to fit perfectly.  This hip joint in very important because it transfers the weight your body onto your legs and allows you to stand, walk and run. 

Causes

Most hip fractures occur in elderly patients where the bones are weakened due to old age, osteoporosis or overuse of steroid medications.  Other causes are injuries from a fall or high impact trauma such as motor vehicle accident or infections such as TB. 

Symptoms

• Extreme pain especially at the groin or upper part of the thigh
• Painful to stand or weight bear
• Difficulty to move the upper part of your leg or knee

Click to view OACMorthopedics video on Hip Fractures

Types of hip fractures

There are 4 types of hip fractures depending on the location. 

• Femoral neck fracture
• Intertrochanteric fracture (at the area below the neck of the femur and above the shaft of the femur between 2 bony landmarks namely the greater trochanter and the lesser trochanter)
• Subtrochanteric fracture (at the upper part of the shaft of the femur below the trochanters)
• Femoral head (which is the ball of the femur which sits in the socket joint)

Treatment Options

Hip fractures require treatment within a few days of injury to prevent complications such as permanent damage to the hip joint or avascular necrosis of the bone.  The type of surgery depends upon the type and location of the fracture, as well as your age and physical condition.  In some cases, internal fixation (using a combination of pins, screws, rod or plate) is required.  When there is a lack of blood supply to the head of the femur due to a displaced fracture or when internal fixation is not suitable, a part or all of the hip is replaced.

Femur Neck Fracture

For a undisplaced femoral neck fracture, in-situ pinning is a common option. This pinning procedure involves surgical pins or screws put in place to hold the ball of the femur in place to prevents the femoral head from dislodging or slipping off of the femoral neck and allow the fracture to heal.

For displaced femoral fracture, a partial hip (hemi-arthroplasty) or total hip replacement is usually recommended

Intertrochanteric fracture

These fractures are usually treated with with either a sliding compression hip screw and side plate or an intramedullary nail to heal stabilise the hip joint while the fracture heals.

Subtrochanteric fracture

The treatment may consists of an intramedullary nail placed into the shaft of the femur and a screw placed through the nail into the femoral head.  Sometimes, interlocking screws may be required to prevent the bones from rotating.  Your surgeon may prefer to place a compression screw with a long side plate instead of using a intramedullary nail.

Post-Op Care

Most patients are encouraged to get of bed and start some form of physiotherapy soon after the surgery. It is important to begin moving as soon as possible to prevent complications such as blood clots (DVT), joint stiffness, lung infection or bed sores.

You may be given medication after your surgery to

• provide pain relief
• prevent infection
• prevent blood clots in your leg called Deep Vein Thrombosis (DVT)

While you are still in hospitals, you are encourage to do some gentle physiotherapy to reduce the risk of blood clots and also prevent hip joint stiffness.

Click to view Calvary video on Physiotherapy after Hip Surgery

Rehabilitation

When you have been discharged home after hip fracture surgery, do follow your doctor’s post-operative and physiotherapy rehabilitation instructions.  They may differ depending on the type of surgery you had done as well as your general health condition.

Discuss the treatment options with your Orthopaedic Surgeon

---

Disclaimer. TELEME blog posts contains general information about health conditions and treatments. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. The information is not advice and should not be treated as such. 

If you think you may be suffering from any medical condition, you should seek immediate medical attention from your doctor or other professional healthcare providers. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.