If one of our elders, perhaps a grandmother or grandfather, slips and falls, it can be very scary, right? We often think, 'Oh, I don't know if I broke my hip.' Actually, breaking this hip, that is, `(Hip Fracture)`, is not a game. It is a serious condition that can affect your life. So, let's talk about this precisely and simply today.
What does it mean to simply break a hip?
Okay, now let's look at what a hip fracture is. Your leg has a thigh bone, which is the longest and strongest bone from the hip to the knee. Doctors also call it the femur. That's the upper part of the thigh bone, specifically the part near the hip joint, which is what we call a hip fracture.
The hip bone is the longest and strongest bone in the body. So, usually, it takes a pretty bad fall or a major trauma, like a car accident, to break it. If you break a hip, most of the time, that means you'll probably need surgery to fix it.
Sometimes we joke with our friends about things like, 'I broke my hip because I got older.' Even though it's just a joke, it's important to remember that a broken hip is a very serious, life-changing accident . If you ignore it, it can lead to serious problems later on.
What are the ways a hip can be broken?
Now, look, our hip joint is a ball -and-socket joint. The ball-like part of the thigh bone (the femoral head) fits into a cup-like socket (the acetabulum) in our pelvis. So when we say 'broken hip', it means that the bone can break anywhere on the top of the thigh bone.
Doctors classify these hip fractures based on where the femur breaks. Let's take a look at what they are:
- Femoral head fractures: This is a fracture of the ball-like part of the femur, the round part at the top of the thigh bone. This is actually a very rare occurrence.
- Femoral neck fractures: Sometimes called subcapital fractures or intracapsular fractures, this is the bridge-like part of the femur between the round head and the long shaft that runs down the side. This is the most common type of hip fracture. It is like the neck of a bottle, so it can be easily damaged.
- Intertrochanteric fractures: There are two bony prominences (trochanters) on either side of the femur. These are where the muscles attach. This is called a fracture in the area between these prominences.
Doctors also name fractures based on the nature of the fracture (i.e., the way it is broken, the shape). Here are a few examples:
- Transverse fractures
- Oblique fractures
- Spiral fractures
- Comminuted fractures – This is like a piece of glass falling to the ground and shattering.
What are the symptoms of this?
These are the common symptoms of a broken hip. If you have one or more of these, you should definitely be concerned.
- I have a very severe hip pain . This pain can also radiate to the groin.
- You can't move your hips or legs, which means your mobility is severely restricted. You can't even bear weight or stand.
- There may be a lump that can be felt in the hand, or a lump that is visible from the outside.
- Swelling occurs.
- Bruises, that means turning blue.
- The hip joint may appear deformed and misshapen when viewed from the outside . The leg may also appear slightly shortened and turned outward.
What are the causes of hip fractures?
Simply put, a hip fracture requires a very serious accident . Because, as we said before, it's a strong bone. The main causes are:
- Falls: Especially if you fall from a high place (like a ladder, roof, tree). However, in the case of an elderly person, it can happen even if you slip and fall while just standing.
- Vehicle accidents: Car, bicycle, and three-wheeler accidents can cause serious injuries like this.
- Sports injuries: Especially in high-impact sports like rugby and football.
Who is more at risk?
Anyone can have an accident and break a hip. But some people are at a higher risk. These are:
- Adults over 65: As we age, our bones become weaker and our balance decreases, making us more likely to fall.
- People with diseases that weaken their bones. For example, if they have ``Osteoporosis`` (bone loss) or ``Osteopenia`` (bone thinning). In these conditions, the bones become brittle like biscuits.
- Women are at slightly higher risk than men, especially after menopause because they are more likely to develop osteoporosis.
- Athletes who play contact sports.
Usually, a hip fracture occurs when a person falls from a height. However, for someone over 65 years of age or someone with weak bones, the chances of breaking a hip are much higher even if they slip or fall while doing household chores or doing daily activities. Imagine, if a grandmother in our house slips and falls in the bathroom... Since bones become a little weaker with age, the chances of breaking a hip are higher even if they fall. The same can happen to someone with `(Osteoporosis)`.
Also, any health condition that affects your balance, stability, or gait can increase your risk of breaking a hip. Some conditions that can reduce balance include:
- ` (Parkinson's disease)` (Parkinson's disease)
- ` (Vertigo)` (Dizziness)
- Gait abnormalities
- Diseases that cause seizures, such as epilepsy.
How does a doctor detect this?
A doctor can tell for sure if you have a broken hip through a physical exam and special imaging tests . If you go to the emergency room (ER) after a bad fall or other accident, the doctors there can diagnose it as a fracture.
The doctor will first ask you how the accident happened, look at the areas of pain, and see if you can move your leg. Then, they will take pictures of your hip and the surrounding area, and use one or more of the following tests:
- Hip X-ray: This can often detect a fracture.
- MRI (Magnetic Resonance Imaging) test: If the X-ray is not clear, or if there is a suspicion of a small fracture, this test can be used to see more clearly.
- `CT scan (Computed Tomography scan):` This test can also take detailed pictures of the bones. This is very useful when planning a surgery.
What are the treatments?
Almost everyone who breaks a hip will need surgery. This is because it rarely heals properly without surgery. The type of surgery you need will depend on the severity of the fracture, its type, your age, your general health, and whether you have other injuries or health conditions. There are two main types of surgery for hip fractures:
- Hip replacement (or hip arthroplasty): If an adult over the age of 65 has a broken hip, they will usually need to have a hip replacement. This involves removing the damaged part of the hip joint and replacing it with an artificial joint made of metal, plastic, or ceramic. It may be a total replacement or a partial replacement.
- Open Reduction and Internal Fixation (ORIF): In this procedure, your surgeon inserts screws, pins, plates, or a metal rod into your hip bone to hold the broken bone in place. This is when the broken pieces of bone heal properly and don't move. Some people need to wear these implants for the rest of their lives. Others can have them removed after their hip heals.
What complications can occur after surgery?
As with any surgery, some complications can occur after hip surgery. It's good to be aware of these as well:
- Avascular necrosis: Especially in femoral neck fractures, the blood supply to the head of the bone is cut off, causing the bone to die.
- Nonunion: The broken bone may not be completely or partially healed, and may require further surgery.
- Malunion: This occurs when a broken bone heals incorrectly and becomes misaligned. This can cause pain and difficulty walking for a while.
- Bone infection (Osteomyelitis): If you have an open fracture (one where the bone has broken through the skin), you are at higher risk of developing a bacterial infection. Infections can also occur at the surgical site.
- Blood clots: Blood clots can form after surgery, especially in the large veins of the legs. These are very dangerous because they can be life-threatening if they travel to the lungs.
- Other related issues: For adults, things like lung infections and urinary tract infections can also occur after surgery.
How are you surviving this?
Sometimes it's not easy to prevent hip fractures, as they often happen unexpectedly, from a sudden fall or other accident. However, follow these general safety tips to reduce the risk of falls and accidents. These are important not only for you, but also for your family:
- Keep your home and workplace tidy and free of unnecessary clutter. Remove wires and loose items from the floor. This will reduce the chances of tripping over yourself or others.
- Install a grab bar in the bathroom to hold non-slip tiles and shower handles.
- If you are over 65 years old, or if someone in your family has osteoporosis, consider talking to your doctor about getting a bone density test . This will help you detect weak bones early and get treatment.
- Follow a diet and exercise plan that helps maintain good bone health . Eat foods rich in calcium and vitamin D. Things like walking and light exercise strengthen bones.
- Always use a suitable tool (like a ladder) when reaching for something upstairs in your home. Never climb on chairs or tables.
- Always wear your seat belt when driving.
- Wear appropriate safety gear for any activity or sport.
How long does it take to heal?
A broken hip takes at least a few months to heal. You may feel better and see improvement over time, and it may take up to a year of treatment. It's like building a house, it's built piece by piece. The time it takes you to heal depends on a few other things:
- The type of surgery you had to have.
- I wonder if you have any other injuries.
- Your age (it takes longer for an older person to recover than a younger person).
- Your overall health (for example, if you have diabetes, recovery may be delayed).
- The reason for the break and the severity of the break.
Your surgeon will tell you what to expect and a recovery time frame that is appropriate for your condition.
You will need to start physical therapy (PT) soon after surgery. This may start while you are still in the hospital. You will need to do PT for several months before you can move and walk properly again. A physical therapist will teach you exercises and stretches to strengthen the muscles around your hip and increase the range of motion in your joint. Doing these exercises correctly is very important for your healing process.
After surgery, you may need to use a walker, cane, or crutches while you recover. Some people need to use these for a longer period of time. Ask your doctor or physical therapist how long you should use these walking aids.
Why is a broken hip dangerous?
Hip fractures are not just a broken limb. This is more serious than that.
Remember, a broken hip is not a game, it is a serious condition that requires emergency medical attention!
In addition to the damage to your femur and hip joint, hip fractures can also cause other serious injuries. This can happen especially if you fall hard or are in a car accident.
Any accident severe enough to break your thigh bone can also damage your femoral artery. If this happens, severe bleeding can be life-threatening if not treated quickly by a doctor. Also, a broken hip and the need to remain immobile after surgery can increase the risk of blood clots.
Serious injuries that cause hip fractures are especially dangerous for adults over the age of 65. As you get older, it takes longer for your body to heal from any injury. This is even more so in a major accident like a hip fracture. Hip replacement surgery (and the recovery time) can be more difficult for an older person. If they have other medical conditions, the situation can be even more complicated.
Studies have found that adults over the age of 65 who have broken a hip are more likely to reduce or stop physical activities like walking after recovery, and to withdraw from social activities and hobbies. This loneliness can affect your overall health and mental well-being. Talk to your doctor about how to stay active after a hip fracture. They can suggest safe ways to stay connected to your loved ones and the things you enjoy.
When do you need to go to the hospital urgently?
Every hip fracture is a medical emergency. If you think you have a broken hip, call 1990 (or your local emergency number) immediately. Call emergency services if you have been in a fall, car accident, or other serious accident and have one or more of these symptoms:
- You can't move your hips or legs.
- There is unbearable pain.
- Your hip or leg looks different, it doesn't look where it used to be, it looks like it's stretched out.
- Sometimes the skin is pierced and bones are visible (this is very serious).
- Your hip is very swollen.
- Along with these other symptoms, a sudden severe bruise (blueness) appears.
What questions should you ask the doctor?
When treating yourself or someone you know with a broken hip, it's a good idea to ask your doctor questions like these so you can get a clear understanding of the situation.
- What kind of hip fracture do I have? How serious is it?
- What kind of surgery will I have to undergo? What can I expect from it?
- What are the possible risks after surgery?
- How soon do I have to start physical therapy (`PT`)?
- How long will it take for me to fully recover? Will I be able to work again?
- What can you do to control the pain?
Can you walk with a broken hip?
No. You can't stand, walk, or put any weight on a broken hip. Putting pressure on the hip can make the fracture worse, dislocate the broken bone, damage the surrounding blood vessels and nerves, and cause other complications and injuries.
Your surgeon or healthcare provider will show you how to stand, walk, and move safely after surgery and during your recovery. Follow their instructions carefully.
Is it okay to shake someone with a broken hip?
If you think someone has a broken hip, call 1990 (or your local emergency number) immediately. Only trained health professionals should move, lift, or move someone with a broken hip. Try to keep the person lying down as still as possible, without moving them. Do not put any pressure on their leg or try to make them stand or walk. Doing so may make the injury worse.
When you call emergency services, ask the person who answers the call for instructions on how to keep the person safe and stable until help arrives.
A broken hip is a scary, traumatic event. Especially since it can happen in a matter of seconds, from a sudden fall or a car accident. Recovering from hip surgery can be a long, difficult process. Celebrate every little bit of progress on your recovery journey. If you have difficulty moving or exercising, tell your doctor or physical therapist. They can help you overcome any challenges you may be facing.
Finally, things to remember
You don't have to live in fear of breaking a hip. But it's important to know what factors can cause it and how to reduce your risk. Talk to your doctor about regular screenings that can detect changes in your bone density or overall health before an accident happens. Protect yourself from falls and keep your bones strong. Because a healthy hip is the key to a free, happy life! With patience and following your doctor's advice, you can recover well from this condition.
` Hip fracture, Hip fracture, Hip fracture, Femur, Falls in the elderly, Osteoporosis, Hip surgery
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