Diagnosis and Treatment of Hip Fractures in Wake County

What is a Hip Fracture?

A hip fracture is a break in the upper quarter of the thigh bone near the hip joint. People over 65 years of age are at the highest risk for a hip fracture, as the risk of falling increases with age. This type of injury can cause potentially life-threatening complications, so it is important to be seen by a doctor as soon as possible if you believe you have broken your hip. Treatment for a hip fracture almost always involves surgery, followed by physical therapy. Learn more about hip fractures and how they are treated at Raleigh Orthopaedic below.

What Part of the Hip Can Break?

Four different parts of the hip can experience a fracture – the femoral neck, intertrochanteric area, subtrochanteric area, and femoral head.

  • Femoral Neck: The top of the femur (thigh bone) and below the “ball” that sits in the hip socket.
  • Intertrochanteric area: The point where the muscles of the thigh and the hip attach; this is where the hip bone starts to protrude.
  • Subtrochanteric area: Within 5 cm distal to the lesser trochanter. Primarily consists of cortical bone. 
  • Femoral head: The “ball” in the ball-and-socket joint that sits atop the femoral neck.

Causes of Hip Fractures

There are a variety of events that can trigger a hip fracture. Most commonly, the injury occurs after an accident, such as a fall or a car crash. In older people with weaker bones, a hip fracture can occur due to a fall from standing height or when the leg is twisted too far. In athletes, a fracture can occur as a result of repeated stress on the hip. This is especially true of long-distance runners.

Symptoms of Hip Fractures

Hip fractures should be treated right away to reduce the risk of medical complications and a more difficult recovery. With that in mind, it is important to be aware of the symptoms of a hip fracture so you can seek out proper medical attention when you need it. Signs and symptoms of a hip fracture can include:

  • Severe pain in the hip and groin area
  • Inability to get up from a fall
  • Inability to walk
  • Inability to put pressure or weight on the leg of the injured side
  • Outward turning of the leg on the injured side
  • Swelling or bruising around the hip area

How are Hip Fractures Diagnosed?

With the help of an orthopedic doctor, a hip fracture can be diagnosed with an X-ray or MRI (magnetic resonance imaging). Most fractures are visible on an X-ray. An MRI scan shows both soft tissue and bones, making it easier to find fine (or hairline) fractures in the hip area. If more testing is needed, your doctor may order a CT scan, which is another way to get a more detailed picture of the hip and the surrounding area. A fourth imaging option is a bone scan, where a dye is injected before the images are taken. Hairline fractures can be highlighted in this way.

Treatment Options for Hip Fractures

Nonsurgical Treatment

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Nonsurgical treatment for hip fractures is very uncommon and not normally recommended. Only in very few cases, where the hip fracture is nondisplaced, will your doctor consider nonsurgical treatment methods. These steps may include walking with the assistance of a walker or crutches, physical therapy, and lifelong treatment of pre-existing conditions (for example, osteoporosis) to prevent future fractures.

Surgical Treatment Options

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Surgery is almost always needed in the event of a hip fracture. Surgery is most effective when performed as soon as possible after the injury. Having surgery done shortly after the injury helps shorten the time you will need to stay in the hospital, and also reduces pain and complications following surgery. The procedure may be delayed if other medical conditions need to be addressed first.

The type of surgery your doctor recommends will depend on your age and the type or severity of your hip fracture. Surgical methods for hip fracture repair include:

  • Hip pinning: Internal hip repair using metal screws, rods, or plates to hold the bone together while the fracture heals. This is the optimal choice when the bones can be properly lined up.  
  • Total hip replacement: The upper femur and hip socket are both replaced with artificial parts. Studies increasingly show total hip replacement to be the most efficient surgery in terms of cost and continued independence after recovery.
  • Partial hip replacement: The hip socket remains in place, but the upper thigh bone (femur) is replaced with an artificial part. Partial hip replacement is often recommended for patients who can no longer live alone or have additional health conditions.

Recovering from a Broken Hip

When surgery is complete, the patient is encouraged to start moving right away to prevent blood clots and bed sores from forming. Physical and occupational therapy will be part of the recovery process. Exercises will focus on increasing range of motion and strengthening the muscles in the area. Sometimes, a stay in a long-term facility is necessary. This type of recovery places an emphasis on learning how to do everyday activities in a new way. The patient learns how to cook, get dressed, use the toilet, and bathe while recovering from surgery. Occasionally, a patient may need a walker or wheelchair to aid with their mobility and independence.

Is There a Way to Prevent Hip Fractures?

Because most hip fractures occur as the result of a fall, home safety is the most effective way to prevent them. Removing clutter that can be tripped over is crucial to reducing the risk of falls in your home. Always use railings when going up or down stairs. The installation of grab bars in bathrooms for older individuals may also be helpful. Proper lighting of the home is also an easy and effective way to prevent falls. Exercise can slow bone loss and support the strength of the hip muscles, which can improve a patient’s balance and help prevent falls. Strengthening the bones through exercise is also a great option, because if a fall does occur, you may be less likely to fracture your hip.

Hip Specialists at Raleigh Orthopaedic

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When it comes to the diagnosis, treatment, and recovery from a hip fracture, our hip specialists at Raleigh Orthopaedic are here to help. Having served the Wake County area since 1919, our team has performed thousands of procedures and provided professional and efficient care to patients of all ages. We want to help get you on the road to recovery, no matter what type of orthopedic injury or condition you are facing. If you have recently fractured your hip, we encourage you to visit our orthopedic urgent care or find a clinic near you to schedule an appointment with Raleigh Orthopaedic today.