Hip Fractures

A hip fracture is classified as a break in the upper ¼ of the femur (thigh) bone. The severity of the fracture depends on the forces involved, and the type of surgery used to treat a hip fracture is based on the bones and soft tissues affected in addition to the level of the fracture.

Hip Anatomy

The hip joint is a ball-and-socket, with the end of the femur making up the “ball,” which allows the upper leg to move and rotate at the pelvis. Injuries to the socket or acetabulum is not considered to be a hip fracture, and is handled as a completely separate procedure.

Causes

Hip fractures typically happen as a result of a fall or impact to the side of the hip. Medical conditions like osteoporosis, cancer, or stress injuries can make the hip more susceptible to fracture.

Symptoms

A patient with a hip fracture will have pain at the outer thigh or groin area, and there will be significant pain when trying to flex or rotate the hip joint.

If the femur has been weakened by injury or disease, there may be aching or pain present in the groin or thigh for a time before the break occurs. If the bone completely breaks, the injured leg may appear shorter than the other leg.

Types of Fractures

There are three different types of hip fractures, which depends on what area of the femur is injured:

• Intracapsular Fracture – This occurs at the neck and head (the “ball”) of the femur, and is typically within the capsule, or the soft-tissue, in which the hip joint itself resides.
• Intertrochanteric Fracture – This type of fracture occurs between the neck of the femur and the bony protrusion below it called the lesser trochanter, which is where a major muscle in the hip attaches to the bone.
• Subtrochanteric Fracture – These fractures happen in the few inches under the lesser trochanter, leading to the rest of the femur.

Treatment

After diagnosing the hip fracture, the patient’s overall health and medical condition will need to be evaluated to decide whether surgery and anesthesia is a viable option.

• Nonsurgical Treatment – Patients who are too ill to undergo anesthesia or who could not walk before being injured may be candidates for nonsurgical treatment. Additionally, some types of fractures may be able to be managed without surgery. There is a risk for fractures to change position during healing, so the doctor will need to follow up with periodic X-rays. Patients who are confined to bed rest during the management of a hip fracture will need to be monitored for infections, bed sores, and the formation of blood clots.
• Surgical Treatment – Anesthesia for the surgery may be general or spinal, and in very rare cases where minimal hardware needs to be used to stabilize the joint, local anesthetic with heavy sedation may be used. To help prevent infection, all patients receive antibiotics during and after surgery. The surgeon’s decision on how to best repair a fracture will be based on where the hip is broken, and the surgeon’s familiarity with the various systems available to manage the fracture.

Your doctor will often prescribe short-term pain relief medications, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. A combination of these may be used to minimize the need for opioids, which can be addictive.

Patients are encouraged to get out of bed the day after surgery with the assistance of a physical therapist, and the amount of load allowed to be put on the injured leg is dependent on the type of fracture and the repair done to it.

If you’ve been the victim of a hip fracture, our team of Board Certified Orthopaedic Surgeons will ensure that you get the care you need so that you can get back to your daily routine as quickly as possible. Request an appointment online, or contact us today at 904-825-0540.