Hip Fractures
A fracture is a very common orthopaedic problem with about 6.8 million coming to medical attention each year. A fracture is basically a broken bone. Fracture, break or crack, all mean the same thing, the integrity of the bone has been lost and the bone structure fails.
Hip fractures in the elderly are most often caused by a fall, usually a seemingly insignificant fall. In younger patients with stronger bones, more common causes of a broken hip include high-energy injuries such as car accidents or sports injury. Hip fractures can also be caused by bone weakened from tumor or infection, a problem called a pathologic fracture. Other risk factors associated with hip fracture are Caucasian race, slightly built individuals and limited physical activity
There are many types of fractures. A complete fracture is a bone break that completely severs the bone across its width. A comminuted fracture results in many broken bone pieces. When the end of a broken bone tears through the skin, it is called an open fracture.
The term 'hip fractures" includes many subtypes of fractures and the differences between them is important because each is treated differently. Three specific fracture include:
- Femoral Neck -below the ball of the ball and socket hip joint (links to detail page - one level deeper)
- Acetabular -the socket of the ball and socket hip joint (links to detail page - one level deeper)
- Intertrochanteric - below the neck of the femur (links to detail page - one level deeper)
In most cases, when you arrive for medical care with a fracture, the doctor will take a history of the injury. Where, when and why did the injury occur? Did the person trip and fall, or did they pass out before the fall? Are there other injuries that take precedence over the fracture? For example, a person who falls and hurts their wrist because they had a stroke or heart attack will have their fracture care delayed to allow care for the life threatening illness. The injured area will be examined and a search will happen for potential associated injuries. These include damage to skin, arteries and nerves.
Pain control is a priority and many times, pain medication will be prescribed before the diagnosis is made. If the doctor believes that an operation is likely, pain medication will be given through an intravenous (IV) line or by an injection into the muscle. This allows the stomach to remain empty for potential anesthesia.
A decision will be made whether x-rays are required, and which type of x-ray should be taken to make the diagnosis and better assess the injury. Two or three x-rays of the injured areas may be taken in different positions and planes to give a true picture of the injury. Sometimes the fracture will not be seen in one position, but is easily seen in another.
