The American Academy of Orthopaedic Surgeons defines a hip fracture as a break in the upper quarter of the thigh bone 23. Approximately 90 percent of hip fractures occur among adults age 65 and older, according to the Centers for Disease Control and Prevention 15. These injuries often lead to severe health problems, reduced independence and premature death. Prompt medical attention often helps reduce the likelihood of complications and increases a patient’s chance of recovery.
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An orthopedic physician may choose to put a patient on bed rest instead of surgical intervention for a number of reasons. If the physician considers the hairline fracture stable, they may feel that the hip has a likelihood of healing without surgery and opt instead for bed rest 3. Some patients may not be healthy enough to undergo anesthesia and are not candidates for surgical intervention. Physicians will follow the patients during bed rest and take periodic X-rays to view how the hip is healing. If a hip fracture suddenly becomes unstable, patients may have to undergo surgical intervention 3. The American Academy of Orthopaedic Surgeons explains that patients will need to be closely monitored during bed rest for complications that often occur during immobilization including bed sores, infections, blood clots, pneumonia and malnutrition 2.
The type of surgical intervention the orthopedic surgeon uses to treat hip fractures depends largely on where along the hip the fracture took place 35. A hairline fracture that occurs at the neck of the femur often only needs screws to hold the bone in place while it heals. This is referred to as an internal fixation. Orthopedic surgeons may add bone nails for added stability. When a person has an intertrochanteric hairline hip fracture the surgeon often must insert a metal screw through the fracture and attach it to a plate that runs alongside the femur 3. This plate is held in place with other screws to help keep the bone stable. The screws allow the bone pieces to compress as it heals, allowing the edges to grow together. Surgeons perform hip surgery under general anesthesia in a hospital setting. Patients often stay in the hospital for a week or less but may need to stay in a rehabilitation center before returning home.
Following a hip fracture, physicians may choose to put a patient on medications known as biphosphonate medications such as ibandronate and zoledronate 3. These medications help build bone density which may reduce the likelihood of future hip fractures 5. Biphosphonate medications can cause side effects such as nausea, abdominal pain and esophageal inflammation. Patients who experience severe side effects may benefit from a once-yearly infusion of zoledronic acid instead, according to the MayoClinic.com 5.
Physicians prescribe rehabilitation following hip surgery to help speed recovery and allow patients to regain the level of function they had prior to surgery. Physical therapists will often have patients up and moving with the help of a walker within 24 hours of surgery. MayoClinic.com explains that patients will work with therapists to improve strength and range of motion 5. Over the next few months, patients will work with both physical and occupational therapists to help promote independence in daily tasks such as toileting, bathing and cooking. In some cases, patients may need a walker or wheelchair to help regain mobility.
- hip X-ray image by JASON WINTER from Fotolia.com