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The Horror of Breaking a Hip

by Dr. Marilyn B. Field


Health News from Senior Healthcare Advisors



“Older adults have a five-to-eight times higher risk of dying within the first three months of a hip fracture compared to those without a hip fracture.” –Sharon Brennan-Olsen, CNN, 2021


Hip fractures are very serious injuries which can lead to life-threatening complications. Seniors are at a higher risk for serious complications as they increase with age.


As we age our bones tend to weaken (osteoporosis). Poor vision, balance issues, and medications increase the likelihood that seniors may fall. Falling is the most common cause of hip fractures.


Nearly 100% of the time, hip fractures require surgical replacement or repair, followed up with physical therapy. Taking the proper measure to maintain bone density and prevent falls can lower your chances of suffering a hip fracture.


Signs and Symptoms of a Hip fracture

  • Inability to get up from a fall or to walk

  • Severe pain in your hip or groin

  • Inability to put weight on your leg on the side of your injured hip

  • Bruising and swelling in and around your hip area

  • Shorter leg on the side of your injured hip

  • Outward turning of your leg on the side of your injured hip



Beyond suffering intense pain, a hip fracture results in decreased socialization, loss of physical abilities, increased dependence, and a much worse quality of life. Many of those who have fractured a hip need to completely change their life, such as entering into a residential senior care facility, or to a different room (i.e. downstairs) in their own home.


Oftentimes, fractures of the hip are a result of a fall, and sometimes they are the cause of a fall. Osteoporosis can actually cause a hip fracture. This condition can weaken the femur bone causing it to suddenly fracture. Just taking an uncertain step can cause you to twist your hip joint placing excess stress on the neck of the femur bone. The femur bone then breaks causing the person to fall to the ground. Because it happens so fast, it is hard to determine whether the fall of the break happened first.




Prevention

Choosing a healthy lifestyle can reduce the advancement of osteoporosis and lower your fall risk, as well as improving your overall health and wellness.


CLICK HERE TO READ ABOUT FALL PREVENTION https://www.seniorhealthcareadv.com/post/the-danger-of-falling

To avoid falls and to maintain healthy bones:

  • Get enough calcium and vitamin D. As a general rule, men and women aged 50 and older should consume 1,200 milligrams of calcium a day, and 600 international units of vitamin D a day.

  • Exercise to strengthen bones and improve balance. Weight-bearing exercises, such as walking, help you maintain peak bone density. Exercise also increases your overall strength, making you less likely to fall. Balance training also is important to reduce your risk of falls, since balance tends to deteriorate with age.

  • Avoid smoking or excessive drinking. Tobacco and alcohol use can reduce bone density. Drinking too much alcohol can also impair your balance and make you more likely to fall.

  • Assess your home for hazards. Remove throw rugs, keep electrical cords against the wall, and clear excess furniture and anything else that could trip you. Make sure every room and passageway is well lit.

  • Check your eyes. Have an eye exam every other year, or more often if you have diabetes or an eye disease.

  • Watch your medications. Feeling weak and dizzy, which are possible side effects of many medications, can increase your risk of falling. Talk to your doctor about side effects caused by your medications.

  • Stand up slowly. Getting up too quickly can cause your blood pressure to drop and make you feel wobbly.

  • Use a cane, walking stick or walker. If you don't feel steady when you walk, ask your doctor or occupational therapist whether these aids might help. (Mayo Clinic.org).

Treatment

The normal course of treatment for a fractured hip is surgery. If possible surgery is conducted within 24 hours of admission to the hospital. Actually, most hip fractures can heal without surgery, but the down time can last up to 4 months. Being bedridden for that long has more risks and complications than the hip surgery. For this reason surgery is almost always recommended for hip fractures.


The goal of this type of surgery is to fasten the broken bones in the hip in a secure position. Most broken hips are treated with a metal plate and screws, metal pins, or a replacement with an artificial femoral head.


  1. Metal Pins: This is a fairly common and simple surgery where two or three metal pins are inserted into the hip bones to hold the two broken pieces together. Patients can start assisted walking the same day.

  2. Metal Plate and Screws: Some hip fractures resulting from a fall have more than one break in the bone, making it very difficult to treat. Because of the multiple breaks, several pieces of fractured bone have to be held together. The surgeon will place a metal plate with a screw to help align the bones and hold them together until they heal.

  3. Artificial Replacement of the Femoral Head: When the ball in the femur neck is totally displaced, there is the possibility that the blood supply to that area has been damaged. Necrosis (tissue death) can occur as a complication to this type of hip fracture. (OrthoNorCal Orthopedics, 2020).

  4. Total hip replacement: Your pelvic bones (upper femur and socket) are replaced with a prosthesis (artificial parts). Holds much better long-term results.

  5. Partial hip replacement: Your surgeon may replace the ends of the broken pelvic bones with a metal replacement.


Complications

A broken hip not only reduces your independence, it can shorten your life. If you lose your mobility and get stuck in one position for a long time, the complications can include:

  • Blood clots in your legs or lungs

  • Bedsores

  • Urinary tract infections

  • Pneumonia

  • Further loss of muscle mass, increasing your risk of falls and injuries

  • Death

Rehabilitation

Your support team will have you out of bed and ambulating (moving) on the first day post surgery. A physical therapist will conduct strengthening and range-of-motion exercises. You may need to transport back and forth to the hospital for physical therapy, depending on whether you have help at home.

You may also work with an occupational therapist, who will teach you techniques and skills to improve your independence in your activities of daily living, such as dressing, bathing, using the bathroom, cooking, etc.

Your doctor might ask:

  1. Have you recently fallen or had another injury to your hip?

  2. How severe is your pain?

  3. Can you put weight on your leg on the side of your injured hip?

  4. Have you had a bone density test?

  5. Have you been diagnosed with any other medical conditions? What medications are you currently taking, including vitamins and supplements?

  6. Do you use alcohol or tobacco?

  7. Have you ever had surgery? Were there any problems?

  8. Do any of your blood relatives — such as a parent or sibling — have a history of bone fractures or osteoporosis?

  9. Do you live independently? (Mayoclinic.org, 2022).

It is important to know ahead of time how imperative prevention techniques are utilized in the lives of seniors. A broken hip can greatly affect your mental health as much as your physical health. Situational depression, and loss of control anxiety are not uncommon in seniors suffering from a hip fracture. Immediate and aggressive prevention protocols and persistent follow-up of mental disorder development appear to be critical with the aged society.




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