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Understanding Hip Fractures: Types, Symptoms, and Treatments

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Understanding Hip Fractures: Types, Symptoms, and Treatments

By Dr. Rakesh Mahajan in Institute For Bone, Joint Replacement, Orthopedics Spine & Sports Medicine

May 31 , 2023 | 3 min read

A hip fracture, or a break in the upper portion of the femur (thigh bone), is a severe injury requiring immediate attention. These fractures are most common in individuals over 60 with weakened bones due to conditions like osteoporosis. However, younger people may sustain hip fractures from high-impact events such as car accidents or significant falls. Almost all hip fractures necessitate surgical intervention and extensive rehabilitation, with recovery often taking up to a year.

What Are the Different Types of Hip Fractures?

Hip fractures are categorized based on the location and type of bone break. The three main types of hip fractures are:

Intracapsular Fractures
Intertrochanteric Fractures
Subtrochanteric Fractures

Intracapsular and intertrochanteric fractures comprise about 90% of all cases. Treatment plans are tailored to the specific type and severity of the fracture.

1. Intracapsular Fractures

Intracapsular fractures occur within the capsule that houses the hip joint. This type of fracture can impact the femoral head and neck. Key points include:

Susceptibility: Common in elderly individuals and those with osteoporosis.
Location: Typically occurs 1-2 inches below the hip joint.
Complications: May disrupt blood supply to the femoral head, increasing the risk of osteonecrosis.

2. Intertrochanteric Fractures

Intertrochanteric fractures occur 3-4 inches below the hip joint, between the lesser and greater trochanters. Notable features include:

Severity: Often easier to repair than intracapsular fractures.
Bone Healing: Generally, these fractures do not compromise blood supply to the bone.
Complex Cases: May involve shattered bone fragments or additional breaks.

3. Subtrochanteric Fractures

Subtrochanteric fractures affect the upper portion of the femur shaft, just below the lesser trochanter. Characteristics include:

Range: Can vary from clean breaks to complex fractures.
Diagnosis: Often identified through X-rays or MRI scans.
Treatment: Requires advanced surgical techniques for stabilization.

Symptoms of a Hip Fracture

Recognizing the signs of a hip fracture is essential for prompt medical intervention. Common symptoms include:

Extreme pain in the hip and groin area.
Inability to walk or bear weight on the affected leg.
Bruising or swelling around the hip.
Shortened leg or outward-turned foot on the injured side.

Causes of Hip Fractures

Factors contributing to hip fractures include:

Age and Gender: Elderly individuals and women are more prone due to weaker bones.
Osteoporosis: A leading cause in older adults.
Trauma: High-impact injuries like car accidents or falls.
Other Risk Factors:
- Family history
- Vitamin D or calcium deficiency
- Physical inactivity
- Chronic conditions (e.g., arthritis, balance disorders)
- Smoking and certain medications

How are Hip Fractures Treated?

Treatment primarily involves surgery to stabilize the fracture and restore mobility. Common surgical procedures include:

Hip Repair Surgery (Internal Fixation): Uses metal screws, rods, or plates to secure the bone.
Hip Replacement Surgery:
- Partial Replacement: Replaces the femoral head.
- Total Replacement: Replaces both the hip socket and femoral head.

Non-surgical treatments, suitable for minor fractures, include:

Activity Modification: Using crutches or walkers to avoid weight-bearing.
Physical Therapy: Strengthening exercises for recovery.
Bone Stimulation: Techniques like low-intensity pulsed sound waves to promote healing.

Understanding Hemiarthroplasty vs Total Hip Replacement can help you make informed decisions about the best treatment option for hip conditions.

Risks and Complications

Elderly individuals face higher risks of complications, such as:

Blood clots and infections.
Pneumonia or bedsores from prolonged immobility.
Chronic pain and reduced mobility.

Preventing Hip Fractures

Reducing the risk of hip fractures involves:

Regular weight-bearing exercises.
Maintaining bone health through adequate calcium and vitamin D intake.
Preventing falls by improving balance and removing hazards at home.

Conclusion

Understanding the types of hip fractures and their treatment options is critical for effective recovery and prevention. If you or a loved one experiences symptoms of a hip fracture, seek medical attention immediately.