If an elderly mother or father in our house slips and falls in the bathroom, the fear that immediately comes to our mind is, 'Oh, I don't know what happened to the hip bone.' Although we joke among ourselves that "when we get old, we will break our hip," this is actually a very serious condition that can affect our lives. But there is no need to be afraid. If we are fully aware of this hip fracture, we can face any situation intelligently.
Simply put, what is a hip fracture?
A hip fracture is a break in the upper part of our thigh bone, near the hip joint. This thigh bone is medically called the 'femur'. This is the longest and strongest bone in our body. So for this to break, it usually requires a serious injury, such as a big fall or a car accident.
But there's something special we need to understand here. While it takes a lot of force to break this bone in a young person, in an older person, especially someone with a condition like osteoporosis , this bone can break even with a small slip and fall at home.
Surgery is often required to repair a broken hip, so this is not a situation to be taken lightly.
Are there different ways to break a hip?
Yes, doctors classify hip fractures into several types depending on where the fracture occurs. Our hip joint is like a ball-and-socket joint. The ball-like part at the top of the thigh bone (femoral head) fits into a socket in our pelvis to form the hip joint. So this classification is based on where the fracture occurs at the top of the thigh bone.
You can easily understand this from the table below.
| Fracture Type | Simple explanation |
|---|---|
| Femoral Head Fractures | This is a fracture of the ball-shaped part at the top of the thigh bone. However, this is very rare. |
| Femoral Neck Fractures | A fracture of the 'neck' of the femur, the bridge that connects the ball-shaped head of the femur to the long bone. This is the most common type of hip fracture. |
| Intertrochanteric Fractures | A fracture of the area between two bony prominences where the muscles connect, just below the 'neck' part. |
What are the symptoms of a broken hip?
Look for these symptoms after a fall or accident. These are the main and most common symptoms:
- Severe, unbearable pain in the hip area.
- Inability to move the hip or leg.
- A lump that can be felt in the hand or a change in appearance.
- Very swollen.
- Bruising and blueness.
- The hips or legs appear unnaturally stretched.
What are the causes of hip fractures and who is at higher risk?
Anyone can break a hip in an accident, but some people are at a much higher risk than others.
The main reasons are:
- Falls (especially falls from heights or slips in the elderly)
- Car accidents
- Sports accidents
Let's see who is most at risk.
| Risk category | Description |
|---|---|
| People over 65 years of age | As we age, bones become weaker and balance decreases, which can lead to fractures even from a minor fall. |
| People with diseases that weaken bones | Conditions such as osteoporosis or osteopenia cause bones to become less dense and more easily broken. |
| Women | Women are at higher risk, especially after menopause, due to hormonal changes that affect bone strength. |
| People with diseases that affect balance | Conditions such as Parkinson's disease, vertigo, or epilepsy increase the risk of falling. |
How does a doctor diagnose this exactly?
When you are brought to the hospital after an accident, the doctor in the Emergency Treatment Unit (ETU) will first examine you. Then, they will do several tests to determine exactly whether the bone is broken, and if so, where and how it broke.
- Hip X-ray: This can often clearly show a fracture.
- MRI (Magnetic Resonance Imaging): This can detect even very subtle fractures that are not apparent on an X-ray.
- CT scan (Computed Tomography scan): This helps to get more detailed information about how the bone broke.
How is it treated? Is surgery necessary?
Almost everyone who breaks a hip will need surgery. The type of surgery you need will depend on the type of fracture, its severity, your age, and your overall health. There are two main types of surgery.
| Type of surgery | What are you doing? |
|---|---|
| Hip Replacement / Hip Arthroplasty | This surgery is usually performed on people over the age of 65. In this surgery, the broken bone is removed and replaced with an artificial joint made of metal, plastic, or ceramic. It may involve a total replacement or partial replacement. |
| Open Reduction and Internal Fixation (ORIF) | Here, the surgeon moves the broken bone pieces back into place and inserts screws, pins, plates, or rods to hold them together until they heal. For some people, these are left in the body for life. For others, they are removed in another operation after the bone has healed. |
What complications can occur after surgery?
As with any surgery, there are some minor risks associated with these surgeries. Some of the main complications that can occur are:
- Avascular Necrosis: Blood flow to the bone is disrupted, causing bone cells to die.
- Nonunion: The failure of broken bones to fit together properly again.
- Malunion: The misalignment of broken bones.
- Bone Infection (Osteomyelitis): Sometimes, especially if the bone breaks through the skin (open fracture), bacterial infection can occur.
- Blood Clots: There is a risk of blood clots in the legs due to prolonged immobility after surgery.
How long does it take to heal?
It can take several months, or even a year , to fully heal after a hip fracture. This is a gradual, gradual process. The time it takes for you to heal depends on several factors:
- The type of surgery you had
- Your age and overall health
- Whether there were any other injuries in the accident
You will need to start physical therapy (PT) soon after surgery. This treatment will last for several months. A physical therapist will teach you exercises to strengthen the muscles around your hip and help you get back to walking.
You will need to use a walker, crutches, or a cane to walk initially. Your doctor or physical therapist will tell you how long you will need to use these.
Why is a hip fracture dangerous? Especially for the elderly...
A hip fracture is a medical emergency because, in addition to breaking the bone, it can also damage important surrounding structures.
Imagine, in an accident serious enough to break the thigh bone, there is a possibility that the femoral artery, which runs nearby, could be damaged. If that happens, it could cause massive bleeding and even be life-threatening.
This condition is even more dangerous for someone over the age of 65. As we age, the body's ability to heal decreases. Therefore, a large wound like this takes longer to heal. Coping with the surgery and the subsequent recovery process can also be difficult for an older person.
The most important thing is that even after an elderly person recovers from a hip fracture, they may still be afraid to walk again, go out in public, or do their own work. The resulting loneliness and reduced activity can have a very negative impact on their overall health.
What can we do to prevent such an accident?
Although we cannot control the dangers, there are many things we can do to reduce the risk.
- Make your home environment safe: Clear your home and work space of unnecessary items and reduce potential tripping hazards. Put a non-slip mat in the bathroom. Make sure there is good lighting.
- Get a bone density test: If you are over 65, or if someone in your family has osteoporosis, talk to a doctor about getting a bone density test.
- Good diet and exercise: Eat foods rich in calcium and vitamin D. Weight-bearing exercise, such as walking, helps strengthen bones.
- Follow safety precautions: Do not climb on chairs or tables to reach anything above. Always use the correct equipment. Always wear a seat belt when riding in a vehicle.
When should you go to the ETU (Emergency Treatment Unit) immediately?
If you suspect a broken hip, it is a medical emergency. Go to a hospital or call an ambulance immediately. Don't delay, especially if you have any of these symptoms after a fall or accident:
- If you can't move your hip or leg.
- If the pain is unbearable.
- If the hip or leg is pulled and looks unnatural.
- If the skin is pierced and the bone is visible.
- If the hip is very swollen.
- If you see a severe bruise along with these symptoms.
Can you walk with a broken hip?
Absolutely not. Do not try to stand or walk with weight on a broken hip. Doing so can worsen the fracture and cause other complications.
Should we move someone with a broken hip?
No. If you suspect someone has a broken hip, call an ambulance immediately. Help the person keep their hip stable and immobile until trained medical professionals arrive and transport them to the hospital. Do not put any pressure on the leg, try to stand it, or try to walk it.
Take-Home Message
- A hip fracture is a very serious, life-threatening condition, especially for the elderly.
- If you have severe pain in the hip area, swelling, and inability to move your leg after a fall or accident, it could be a hip fracture. Go to the ETU immediately.
- Surgery is often necessary, so it is very important to follow your doctor's instructions exactly.
- The recovery period can be long. Physiotherapy is essential to the healing process during this time.
- This risk can be reduced by making the home environment safe to prevent falls and by eating a calcium-rich diet and exercising to keep bones strong.
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