Approximately 200,000 Americans age 65 years or older are hospitalized each year due to hip fractures, and 95 percent of those happen because of falls. Unfortunately, it’s a trend that may increase as our population ages.
So, here are the answers to seven common questions about hip fractures:
- What actually breaks in a hip fracture?
The hip is a ball-and-socket joint. One type of fracture, called a subcapital fracture, happens in the neck of the femur bone, which is right below the ball. A second type of hip fracture occurs in the bend of the femur, which we call an intertrochanteric hip fracture. Those are the two most common that we see. - What are the typical causes of these fractures?
As you get older, calcium leaches out of your bones and weakens the bone, also known as osteoporosis. That’s the biggest underlying condition that leads to a hip fracture. When a person falls and twists the hips, the bones are weak and the hip is fractured from the impact of the fall. - Do all hip fractures require surgical repair?
Surgery is the best choice in most typical hip fractures. If you don’t operate, the potential for complications, like permanent immobility, go up exponentially. Because patients are usually elderly, any additional loss of mobility can really influence quality of life and lead to a range of health issues. - How quickly after an injury do you operate?
A hip fracture usually keeps a patient immobile and causes a lot of pain. Often, the patient calls an ambulance and is brought to the emergency room immediately, and then we operate within 24 hours. - How are hip fractures repaired?
The surgical repair depends on the type of the fracture. If the femur ball is still in good position, we insert a few pins to reinforce and heal the bone. If the fracture displaces the ball off the femur, the blood supply can be interrupted, and that often requires replacing the femur ball with an artificial metal one. In this type of repair, the patient can usually walk on it right away after surgery.If the bones come out of their normal position, a surgeon will replace them and repair them with a large screw and plate (called a compression hip screw) or a rod inside of the femur (called a cephalomedullary nail). These will hold the bone together until the fracture heals. In this case, most patients will be allowed to bear weight as soon as they feel comfortable.In cases where the patient is healthy and active, and will use the hip joint quite extensively, we often consider a total hip replacement, meaning we replace both the ball and the socket.
- What types of materials are used with hip replacements?
Titanium is used most often. Once the metal support structure is in place, materials can be snapped into that structure to hold the weight usually held by the hip, this is the part that does the moving and turning. The inserts for the ball surface are typically metal or ceramic, and the inserts for the socket are usually a hard and smooth plastic. - What is the typical recovery time?
Once the surgery is complete, depending on the procedure and the patient’s overall health, an individual will probably be in the hospital an additional two to three days. We want to have all patients up and walking the next day when possible.There are many factors to consider, but, in general, a younger and healthier patient may go home after a few days. Older patients, or those requiring more follow-up, would likely go into a rehab center for one to three weeks.
Dr. Michael O’Brien is a guest writer from OrthoCincy.
