Hip Fractures

A hip fracture is a break in the upper quarter of the femur (thighbone). The hip is a ball-and-socket joint that supports our upper body and allows us to be mobile and active. The ball is the upper end of the femur — called the femoral head — which fits into the socket (a cup-like depression) in the pelvic bone — called the acetabulum. Although the acetabulum is technically part of the hip joint, fractures of the acetabulum are referred to as pelvic fractures, not hip fractures.

Here at YourOrthoSolution, we have some of the top orthopedic surgeons and sports medicine physicians in the country. We are dedicated to getting you back to the things you love through a customized plan that fits only you. Our caring team always goes that extra step to make you feel like part of our family. We specialize in treating hip injuries, including fractures, and want to help you start the healing process as quickly as possible to get you on the path to recovery.

Types

There are three types of hip fractures, based on their location within the femur:

• Intracapsular – this fracture occurs within the uppermost part of the femur. It is located at the femoral neck, which is the area immediately below the femoral head (the ball that fits in the acetabulum). It is generally located within the hip joint itself. The hip joint is enclosed in a connective tissue capsule, which is why this is called an intracapsular fracture. Because of the location of the blood vessels in the area, these types of fractures may interfere with the blood flow to the femoral head. Even with appropriate treatment, avascular necrosis (death of cells due to an inadequate blood supply) of the femoral head may occur.
• Intertrochanteric – this fracture occurs further down in the femur, between two protuberances (lumps) called the greater trochanter and the lesser trochanter. The greater trochanter lies in the upper and outer part of femur and can be felt as a hard lump near the side pocket area of your pants. The lesser trochanter is a small protrusion on the inner side of femur. Both the greater and lesser trochanter have connections to many important muscles in the pelvis and thigh.
• Subtrochanteric – this fracture occurs below the lesser trochanter, in the area covering the rest of the upper quarter of the femur.

Causes

Hip fractures are most commonly caused by a fall or direct blow to the side of the hip. They are extremely common in older individuals. Age-related osteoporosis is a major factor contributing to the large number of hip fractures in the elderly. Osteoporosis weakens the bones, leaving them more susceptible to breaking. With severe osteoporosis, it is even possible for the hip to break while a person is merely standing.

Symptoms

Hip fractures produce pain over the outer upper thigh or in the groin. The pain worsens with any attempt to bend or rotate the leg at the hip. A person with a hip fracture will often hold the leg as still as possible, with the foot and leg turned outwards. The leg with the hip fracture may also appear shorter than the other leg. Sometimes, a person with osteoporosis notices an ache in the groin or thigh area before the actual break occurs.

Treatment

A person with a suspected hip fracture requires immediate medical attention in an emergency room.

Nonsurgical

Hip fractures are rarely treated with nonsurgical methods. These methods are usually reserved for people considered to be too frail or sick to be able to tolerate the surgery or anesthesia.

A hip fracture, even if it seems to be in proper position, can easily become displaced, making surgery the preferred treatment. In addition, nonsurgical treatment requires prolonged bed rest with little to no movement, which can lead to various complications, from bed sores to blood clots to impaired mobility in the future.

Surgical

Most surgeons agree that people do better if they are operated on fairly quickly. Nevertheless, surgery is not a true emergency, so the operation may be delayed a few days to make sure the person is in the best possible shape to be able to safely undergo hip fracture surgery.

The best surgical technique will be depend to a large extent on the area of the hip that is broken. Age and condition of the femur are other factors that may be considered. Screws, plates, and/or intramedullary nails are used. Sometimes, screws can be inserted without the need for an incision (called percutaneous pinning), but in most cases, a relatively large surgical incision is required.

For older individuals with an intracapsular fracture, the possibility of developing avascular necrosis of the femoral head is so high that the head is often removed and replaced with an artificial head, as in hip replacement surgery. If only the head is replaced, this is referred to as a partial hip replacement. Sometimes the surgeon decides to replace the acetabulum as well, in which case the surgery is a total hip replacement.

As with all of our treatments programs, the goal is to get you back to full strength and doing the activities you want to do. Our highly trained specialists will take into account several factors and create a customized treatment plan designed specially for you and your needs.

At YourOrthoSolution, all of our doctors and staff are committed to ensuring that you not only receive the best orthopedic care in the area but also have an exceptional experience each time you visit our locations. Our dedicated staff will handle all insurance processes for you. You can expect to be in a friendly atmosphere and receive top orthopedic treatment to help you return to your normal activities as quickly as possible.