hip fracture


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hip fracture

vernacular term for fracture of the femoral neck, typically resulting from a fall in an old person with osteoporosis; more common in women; requires surgical repair with internal fixation and can lead to prolonged or permanent loss of mobility and shortened life span.

hip fracture

Orthopedic surgery A femoral fracture which affects 1/6 white ♀–US during life Epidemiology 250,000/yr–US Specifics Proximal femur; 90+% femoral neck, intertrochanteric; 5-10% are subtrochanteric Risk factors Tall, thin ♀, osteoporosis, previous Fx or stroke, white, use of walking aids, alcohol consumption, poor health, sedentary lifestyle, Rx with benzodiazepines, anticonvulsants; HRT may protect ♀ < age 75, institutional residence, visual impairment, dementia Diagnosis Hx, plain AP film, MRI, 99mTc bone scan. See Falls, Total hip replacement.

hip frac·ture

(hip frak'shŭr)
Vernacular term for fracture of the femoral neck, typically resulting from a fall in an old person with osteoporosis; more common in women; requires surgical repair with internal fixation and can lead to prolonged or permanent loss of mobility and shortened life span.

hip fracture

A fracture of the proximal portion of the femur, i.e., of either the head, neck, intertrochanteric or subtrochanteric regions of the hip. Hip fracture occurs each year in approximately 225,000 Americans over 50. It is more common in women than in men due to osteoporosis and is esp. common in slender, elderly women. Mortality rates after hip fracture are influenced by the patient's age, general physical health, and the type of fracture.

Etiology

Osteoporosis predisposes an elderly person to hip fracture.

Symptoms

Pain in the knee or groin is the classic presenting sign of a hip fracture. If the femur is displaced, shortening and rotation of the leg may be present.

Treatment

Preoperatively, Buck's traction may be used in the short term to alleviate muscle spasms. An open reduction is the preferred surgical treatment. A femoral prosthesis may be used for femoral neck or head fractures. The bone takes 6 to 12 weeks to heal in an elderly patient.

Patient care

During hospitalization, general patient care concerns apply. The patient is prepared physically and emotionally for surgery according to the orthopedic surgeon's protocol, and postsurgical care and pain control (epidural or intravenous patient-controlled analgesia [PCA]) is discussed. Neurovascular status of the affected limb is assessed according to protocol and compared to the unaffected limb. The patient is referred for physical and occupational therapy and uses a walker until the bone is completely healed. Prevention and relief of pain and monitoring of postoperative complications, including infection, hip dislocation, and deep venous thrombosis or pulmonary embolism, are primary concerns. Use of an incentive spirometer is encouraged to prevent atelectasis and respiratory complications. Prophylactic antibiotics and anticoagulants are administered as prescribed, and hip precautions are implemented to prevent dislocation. These precautions include having the patient avoid hip adduction (usually by an abductor wedge), rotation, and flexion greater than 90° during transfer and ambulation activities, and by using a raised toilet seat and semi-reclining chair. The patient is typically hospitalized for 2 to 4 days and then discharged to a nursing home, subacute unit, transitional care unit, rehabilitation center, or home for rehabilitation for several weeks.

See also: fracture
References in periodicals archive ?
The consequences of hip fractures to older people can be devastating, including impaired mobility and loss of independence.
USA], Sep 09 (ANI): Older individuals, especially men, with hip fractures are more than 3.
Two researchers independently identified the titles and abstracts related to effect of bisphosphonates for elderly patient with hip fracture, and full text of all potentially relevant studies were obtained to identify whether it can be included.
Femoral neck geometry and hip fracture risk: The Geelong osteoporo sis study:Osteoporos Int.
Our data suggests that preoperative TTE may provide little benefit in managing hip fracture patients.
Major findings: If all women 65 years of age and older who have had a distal radius fracture went on to receive bisphosphonate treatment, 94,888 lifetime hip fractures would be avoided, but at a cost of $205,534 per averted fracture, and with an additional 19,464 atypical femur fractures.
To improve resistance and to prevent new fractures on controlateral non-fracturated osteoporotic hip, we injected cement and K wires, in controlateral hip fracture, during the same intervention, using a single anesthesia.
Legumes and meat analogues consumption are associated with hip fracture risk independently of meat intake among Caucasian men and women: the Adventist Health Study-2.
Higher levels of omega-3 fatty acids in the blood may reduce the risk for hip fractures in postmenopausal women, suggests a study in the Journal of Bone and Mineral Research.
The staff manning the theatres was specifically trained on the use of equipment relating to hip fracture surgery.
In 2010, approximately 258,000 persons aged [greater than or equal to] 65 years were hospitalized for hip fractures (4).