Hip Fracture in Elderly Patients

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What Causes Hip Fracture?


Hip fractures occur most frequently in elderly patients when they fall due to weak bone structure. Even a simple fall of the elderly can be a sufficient reason for a hip fracture. Osteoporosis plays a major role in hip fractures caused by a simple fall. A patient with a weakened bone may even trip and fall at home, causing a hip fracture.




In some cases, it is even possible for the hip to fracture spontaneously in people whose bones are too weak. The blood pressure irregularity, visual impairment, and decrease in reflex and muscle strength in the elderly make it possible for the patient to fall. Long-term use of osteoporosis drugs can also make the bone rigid, causing fractures to develop more easily. In young people, it is usually seen as a result of serious accidents.


What Are the Symptoms of a Hip Fracture?


  • Severe pain occurs in the groin or upper thigh.
  • There is swelling and tenderness.
  • Severe bruising or redness is seen on the hip.
  • A person with a hip fracture has discomfort when rotating their hip.
  • The patient can not sit, lie down, walk, or have a lot of difficulty walking on their hips.


How is a Hip Fracture Diagnosed?


Displaced hip fractures are easy to diagnose. The patient is unable to walk and there is severe pain in the hip area that increases with movement. The leg on the broken side is shortened and turned outward. X-rays are often sufficient for diagnosis. However, x-rays may not be sufficient in some fractures that have not displaced. In these cases, advanced diagnostic methods such as computed tomography and magnetic resonance are applied additionally.


Hip fracture should be suspected in elderly patients who complain of pain in the hip and inability to walk after a fall, and the patient should be taken to the hospital by ambulance as early as possible. Fracture should be considered and examined in unexplained hip or groin pain in the elderly.


What are the Types of Hip Fracture?


There are 3 types of hip fracture, including femur fracture, trochanteric fracture and subtrochanteric fracture. These types are determined by the location of the fracture.


Fracture of the femur: A fracture of the femur is caused by trauma to any part of the thigh bone, which we call the femur, which lies between the hip joint and the knee joint. The major symptom of a femoral fracture is severe pain and swelling. It is more common in women over 60 years of age than in men. Definitive diagnosis is made by X-ray.


Trochanteric fracture: Trochanteric fracture is more common in people over 70 years of age. 


Subtrochanteric fracture: Subtrochanteric fracture occurs as a result of strong traumas such as traffic accidents, gunshot wounds, and falls. Subtrochanteric fractures are known as fractures that occur in the upper part of the femur.




How Is The Hip Fracture Treatment?


Hip fractures seen in the elderly are extremely important and vital fractures. Because if such a fracture is not treated, the patient can't get up from the bed. Unable to perform activities of daily living. Since the patient can't get out of bed and move due to the fracture, wounds appear on the back of his body and his lungs may begin to collect water.

For this reason, treatment of hip fracture should be planned without losing time so that the patient can continue his life in a healthy way.


The hip fracture and treatment process should begin as soon as possible in patients with hip fractures. In this way, the time to regain their lost health will be faster. For example, if a patient with a broken hip is operated on within 24 hours, most of the time the patient does not even notice the fracture. If the operation period lasts longer than 72 hours, mortality and morbidity rates increase significantly.


The treatment varies according to the type of fracture, the age of the patient and the general health condition. Non-surgical treatments may be preferred for fixed fractures. During this period, the patient should lie down, not stand up or walk. He should get plenty of rest. Close X-ray follow-up is performed in case of risk of slippage in the fracture.


In surgical treatment, prosthesis or osteosynthesis is applied according to the age of the patient, the strength of the bones and the general condition of the femur fracture. Nailing or screwing is applied in people who have hip fractures at a young age to fuse the fractures.


In the elderly, total or partial prosthesis treatment is applied because the possibility of union of the broken bones is low. In the treatment of trochanteric and subtrochanteric fractures, compression hip nailing surgery is generally preferred for the purpose of union of the bones.




Post-Surgery Process


Patients should receive physiotherapist support so that they can get out of bed after being discharged to their homes or rehabilitation center after surgery.  Explain the exercises to the patient. Encouraging the patient to stand up and perform daily activities by being supported after surgery is at least as important as the surgical procedure.

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