What's the Big Deal about Hip Fractures?

Sleet, freezing rain, drizzle, glare ice, black ice, ice on roads and sidewalks make for difficult mobility and driving on these winter days. We in Minnesota adapt our driving during winter, but do we consider possibility of falling when walking? We would do well to take precautions.

Hip fractures are a serious injury, and complications can be life-threatening.

Falling is a common cause for a fractured hip, but motor vehicle accidents often result in fractures as well. There is at times a spontaneous fracture of the hip due to osteoporosis (thinning of the bones with age); in that situation, often one will sustain a fracture by simply turning over in bed, or suddenly twisting to the side. It is not uncommon that in one with significant osteoporosis, the actual spontaneous break of a hip is what causes the person to fall.

Symptoms of a hip fracture are not vague. It is rare that someone “walks around” very long with a fractured hip. Signs and symptoms include being unable to walk, severe pain in the hip or groin, inability to bear weight on one side, one leg being acutely shorter than the other, the turning outward of the leg toward the side of the injured hip, and sometimes swelling and bruising around the hip area. The swelling and bruising results from bleeding into the fractured joint. It's hard to imagine that a broken bone can cause significant blood loss, but it's understandable when one thinks of the rich blood supply throughout the body, and especially in these large hip joints that bear the weight of mobility.

For females one in three individuals will have a hip fracture throughout their life, while just one in twelve males will experience that. Despite what you think, that's not because of the 'macho man' strength of the males. The risk of fractures increases as a person ages, and females have a longer life expectancy than males. The aging process includes risks for falling with decreased balance, loss of muscle mass, problems with vision (can you see where you're going?). Individuals with chronic medical conditions are more prone to fractures; those with digestive issues do not absorb nutrients from their food, and develop chronic deficiencies in elements such as calcium and vitamin D. Thyroid disease can result in thinning of bones, increasing risk of fracture. The often-useful drug Cortisone/Prednisone has many benefits, but over long term use can contribute to loss of bone density, aka osteoporosis.

A hip fracture can reduce your future independence and sometimes even shorten your life. About half the people who have a hip fracture are not able to regain the ability to live independently. The need for immobility during the immediate recovery phase of treatment is very risky for older individuals. The complications of a fracture can involve blood clots in legs or lungs, bedsores, pneumonia, urinary tract infection, and further loss of muscle mass increasing the likelihood of additional falls with potential additional fractures.

The clinical suspicion of hip fractures requires definitive diagnosis with xray and/or an MRI to determine the nature and exact location within the joint of the fracture. Depending on the exact location and extent of the fracture, the surgical treatment may be one of three options: internal repairs with screws and metal plates to secure the bones in alignment; partial joint replacement; or total joint replacement. The surgeon evaluates which procedure is more likely to provide optimal healing and return to normal mobility. After the surgical repair, the individual needs rest, with scheduled physical and occupational therapy. Following a few days in the hospital, it is common for the patient to spend some weeks at a rehabilitation facility to continue these therapies.

Yes, it is a big deal to have a fractured hip. Would you like some tips on how to maintain healthy bones and avoid falls?

·         Get enough calcium and vitamin D in your diet or take supplements;

·         Exercise regularly to maintain balance and strengthen bone, use a cane or walking stick, or walker if needed;

·         Avoid tobacco and alcohol which can reduce bone density, and impair balance;

·         Have your eyes checked regularly; you need to see where you're going, use nightlights in your home;

·         Remove hazards in your home such as rugs, placement of electrical cords, excess furniture which often contribute to falls;

·         Review regularly with your primary physician the medications you take, and whether you have any side effects from them such as dizziness, blurred vision, weakness.

Enjoy the winter weather to the extent that you can be safe.

Here's to your health!