We've all heard of an elderly grandmother or grandfather who slipped and fell in the bathroom and "broke his hip." Sometimes we joke with our friends that "you shouldn't break your hip just because you're old." But actually, breaking a hip is not something to be taken lightly. This is a very serious, sometimes life-changing accident. So today, let's be aware of this.
Simply put, what is a hip fracture?
This is when the top part of your thigh bone (which we medically call the Femur ), which is near the hip joint, breaks. You know, the thigh bone is the longest and strongest bone in our body. So for it to break, it usually has to be a pretty big impact, like a hard fall or a car accident. When you break a hip bone, it almost always requires surgery to fix it.
Our hip joint is like a ball-and-socket joint. The ball-like top of the thigh bone fits into a socket in our pelvis. Any fracture in this area is commonly called a hip fracture.
Are there types based on the location of the break?
Yes, doctors classify this according to where the femur breaks.
- Femoral head fractures: This is a fracture of the ball-shaped part of the thigh bone. However, this is very rare.
- Femoral neck fractures: A fracture of the bridge-like part (neck) of the femur that connects the ball-shaped head and the long bone. This is the most common type of hip fracture.
- Intertrochanteric fractures: A break in the area between two bony prominences around the neck of the bone, where muscles and tendons attach.
What are the symptoms of a broken hip?
When a hip fracture occurs, one or more of these symptoms are usually seen. It is very important to recognize these.
| Symptom | Description |
|---|---|
| Severe pain | Unbearable, severe pain in the hip area. |
| Inability to move | Inability to move, bend, or bear weight on the hip or leg at all. |
| Swelling and bruising | Swelling of the injured area and blue/purple discoloration of the skin. |
| Deformity | The hip looks abnormal compared to the other side, the leg is turned out or is shortened. |
| Feeling/seeing a knot | Feeling or seeing something like a lump at the fracture site. |
What are the main reasons for this accident?
Normally, a strong bone like this needs a strong impact to break.
- Falls: especially from a height (ladder, roof).
- Car accidents: This can happen more often in serious car accidents.
- Sports accidents: Accidents that occur during contact sports.
But remember, for someone over the age of 65 or someone with a disease that weakens the bones (e.g. osteoporosis), the risk of breaking a hip is much higher, even from a minor slip and fall at home.
Who is most at risk?
Although anyone can break a hip in an accident, some people are at higher risk.
| Risk factor | A short description |
|---|---|
| Being over 65 years of age | This is because bones naturally weaken and balance decreases as we age. |
| Bone-weakening diseases | Conditions such as osteoporosis or osteopenia. |
| Being a woman | There is a greater tendency for bones to thin due to hormonal changes, especially after menopause. |
| Diseases that affect balance | Diseases such as Parkinson's disease, frequent dizziness (Vertigo) or epilepsy. |
How does a doctor diagnose this?
After you are brought to the hospital, a doctor will often examine you in the Emergency Department (ETU). They will examine your hip and leg, checking for pain, swelling, and changes in appearance. They will then do one or more of the following tests to confirm the fracture and determine its exact nature.
- Hip X-ray
- MRI scan
- CT scan
How is it treated? Is surgery necessary?
Yes, almost everyone who breaks a hip will need surgery. The type of surgery you need will depend on the nature of the fracture, your age, and whether you have other health problems. There are two main types of surgery.
1. Hip Replacement / Hip Arthroplasty: This treatment is usually performed on people over the age of 65. It may be necessary to replace the entire joint (total replacement) or only part of it (partial replacement).
2. Open Reduction and Internal Fixation (ORIF): In this procedure, the surgeon inserts screws, pins, plates, or a metal rod to hold the broken bone pieces together until they heal. Some people have these in place for the rest of their lives. Others have to have them removed after the bone heals.
Can complications occur after surgery?
As with any surgery, there is a risk of complications.
- Avascular Necrosis: A section of bone dies when the blood supply to the bone is cut off.
- Nonunion: The broken bone pieces do not fit together properly again.
- Malunion: A misalignment of bone fragments.
- Bone infection (Osteomyelitis): If the broken bone penetrates the skin (open fracture), the risk of bacterial infection is high.
How long does it take to heal?
A broken hip takes at least several months to fully heal. It can take up to a year for you to gradually feel better. The time it takes for you to heal depends on several factors:
- Type of surgery performed
- 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. You will need to do PT for several months. It will help you strengthen the muscles around your hip and get you walking and moving again. You may need to use a walker, crutches, or a cane at first.
Why is a hip fracture such a dangerous accident?
This is a medical emergency because, in addition to breaking the bone, it can also damage vital organs around it.
The most important thing is that in an accident severe enough to break the femur, the femoral artery that runs nearby can be damaged. If that happens, excessive bleeding can be life-threatening. There is also an increased risk of blood clots.
This can be especially serious if the accident happens to an elderly person. As they age, the body heals more slowly. Surgery and the recovery period that follows can be very challenging for them. Some studies have found that older people who have suffered a hip fracture are less likely to walk and withdraw from social activities even after they recover. This loneliness can affect their overall health.
Can an accident like this be prevented?
Although we cannot control accidents, there are many things we can do to reduce the risk.
- Make your home environment safe: Remove slippery objects, tangled wires, and other objects from the floor. Put a non-slip mat in the bathroom. Make sure there is good lighting.
- Take care of your bone health: Eat foods rich in calcium and vitamin D. Talk to your doctor and engage in appropriate exercise.
- Get a bone density test: If you are over 65 or have a family history of osteoporosis, talk to your doctor about getting a bone density test.
- Wear safety equipment: Always wear a seat belt when driving. If you play sports, wear appropriate safety equipment.
- Be careful when reaching for things from heights: Don't climb on chairs or tables to reach for things. Use a suitable ladder or something.
When should you go to the Emergency Treatment Unit (ETU)?
If you suspect a broken hip, it is always an emergency. Call an ambulance immediately. If someone has fallen and has the following symptoms, seek immediate medical attention.
| Situations when you need to go to the hospital immediately | |
|---|---|
| 1. | If the hip or leg cannot be moved at all. |
| 2. | If there is unbearable, excessive pain. |
| 3. | If the hip or leg is abnormally stretched and has changed shape. |
| 4. | If the broken bone is visible through the skin. |
| 5. | If the affected area is excessively swollen and bruised. |
Is it okay to shake or lift someone with a broken hip?
Not good at all. If you suspect someone has a broken hip, call an ambulance immediately. Until trained medical professionals arrive and transport him/her to the hospital, all you can do is try to keep him/her still. Do not put any weight on the leg, try to stand or walk.
Take-Home Message
- A hip fracture is a very serious and urgent medical condition. It should not be taken lightly.
- Although this is most common among the elderly, it can occur in a serious accident to anyone of any age.
- Surgery is often necessary for treatment.
- The recovery period can be long, and patience and physical therapy are essential.
- Especially in homes with elderly parents, it is very important to take the necessary safety measures to prevent them from slipping and falling.
- If you suspect a hip fracture, do not try to move the patient yourself, but call an ambulance immediately.
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