A hip fracture occurs when the femur (thigh bone) breaks. It is usually the result of a fall, though it can also be caused by direct blows to the hips during traumatic events like road traffic accidents. Hip fractures can also be caused by medical conditions like cancer and osteoporosis.
Regardless of the cause, symptoms of fractured hips include pain over the upper thigh or groin region which increases when the person tries to move the leg.
According to the National Center for Biotechnology Information, the classification of hip fractures depends on whether the thigh bone breaks at the femoral neck, the intertrochanteric region, or at the subtrochanteric level.
Femoral Neck Fractures
Fractures of the femoral neck occur in a narrow section of the thigh bone, which lies just below the head of the femur. These fractures are also referred to as intracapsular fractures, since most of them occur inside the capsule that surrounds the joint. Femoral neck fractures can damage the arteries that supply blood to the head of the femur. This can lead to a condition known as avascular necrosis, in which the round head of the femur flattens and develops irregular joint surfaces which cause arthritis.
Fractures of the femoral neck are usually treated surgically, with the surgeon attempting to fix the broken bone with screws. In older patients with displaced fractures, the orthopedic surgeon may also do a total hip replacement and replace the head of the femur and the acetabulum (hip socket) since they have a higher risk of developing arthritis due to the disruption of blood supply to the femoral head.
The American Academy of Orthopedic Surgeons describes intertrochanteric fractures as those which occur below the femoral neck and the lesser trochanter. The lesser trochanter is a bony prominence on the femur that serves as an attachment point for hip muscles.
Intertrochanteric fractures of the hip are treated surgically with a compression hip screw, which is fixed on the outer side of the femur. These fractures can also be fixed with an intramedullary nail that is inserted into the thigh bone.
Subtrochanteric fractures occur below the lesser trochanter. According to John Hopkins Medicine, they are less common than fractures of the femoral neck and those of the intertrochanteric region.
Subtrochanteric fractures are treated with an intramedullary nail, which is inserted into the femur. These fractures can also be treated with locking plates placed on the outside of the femur and secured with screws.
After surgery to treat hip fractures, most patients stay in the hospital for a few days before being discharged. They are usually sent home with pain killers and medications to thin their blood and prevent clots. Rehabilitation is begun during their hospital stay and it is determined by the type of fracture they sustained and how it was treated. Patients continue with their exercises once they are discharged, in order to regain their muscle strength and mobility.
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