By Aaron Rossi, MD
Winter is rapidly approaching and unfortunately, orthopedic surgeons will be seeing an increase in patients with a hip fracture, commonly called a broken hip. Why? Snow and ice causes an increase in falls — especially among older adults. One of the more frequent consequences of falling is suffering a broken hip. In fact, according to the National Institutes of Health, 90 percent of hip fractures result from a simple fall.
The consequences of hip fractures are significant. Only one in four hip fracture patients make a full recovery. Twenty percent of hip fracture patients die within a year of their injury. Among patients who were living independently prior to a hip fracture, only about half are able to walk unaided after fracture and about one-fifth require long-term placement in a care facility. This number is expected to continue to rise due to increased life spans and an aging baby boom generation.
The hip is made up of the largest bone in the body — the femur or thigh bone. When hips are healthy, they are extremely strong and stable and it takes great force to hurt them. However, a large number of Americans do not have healthy bones, including the hip. They suffer from osteoporosis, which is a disease characterized by low bone mass, leading to deterioration of bone tissue. A significant factor in hip fractures is osteoporosis. The weak, porous bones break easily, thus greatly increasing the risk of sustaining a fracture. It is estimated that more than 10 million people over age 50 in the U.S. have osteoporosis, and another 34 million are at risk for the disease. Many people with osteoporosis don’t even know they have it until they break a bone because the disease does not cause any symptoms.
According to the AAOS (American Academy of Orthopaedic Surgeons and American Association of Orthopaedic Surgeons), “osteoporosis plays a role in 90 percent of all hip fractures. Many of these fractures occur in women who have been undiagnosed and untreated for osteoporosis and many of these fractures can be prevented. While women are affected in far greater numbers than men, men are also at high risk — especially in the 85 years and older age group. Studies have shown that the proportion of men with hip fracture is increasing.”
Clearly, a broken hip is a serious condition, especially for older adults. And unlike some other injuries, a hip fracture almost always requires surgery. There are several different types of hip fractures and the exact type of surgery will depend on where the fracture occurs, the type of break it is, as well as patient characteristics like age, overall health, and other medical conditions.
If you remember back when you studied human anatomy, the top portion of the femur is the ball portion or femoral head — part of the hip joint. Just below that is the neck and below the neck there is a long shaft. The neck and just below the neck are the most commonly fractured areas of the femur. The most common type of break is called a Femoral Neck Fracture and this happens about 1 to 2 inches from where the head of the bone meets the socket. This surgery usually involves a hip pinning procedure where special screws are placed to hold the bones in their correct position. A fracture that occurs 3–4 inches away from the neck joint is called an Intertrochanteric Hip Fracture. This may require a metal plate or a rod that goes down the shaft of the femur along with a smaller rod that is placed into the head of the femur. Sometimes the fracture may happen in the ball and socket portions of the hip. If the fracture is severe enough, the femoral head is actually removed and a “partial” hip replacement is performed.
Each type of fracture is treated differently and each treatment depends on the severity of the fracture. Preventing falls can prevent hip fractures. In addition, get screened and if needed, treated for osteoporosis.
For more information, you may contact Central Illinois Orthopedic Surgery at 309-662-2278 or www.ciosortho.com. Their office is located at 1505 Eastland Dr., Suite 220 in Bloomington. Dr. Keller and Dr. Nord have been providing orthopedic care to the Bloomington-Normal area for over 30 years.
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