Hip Fractures: Overview

Hip Fractures: Overview

This video will provide an overview of breaks in the hip known as hip fractures. The hip is a ball-and-socket joint connecting the pelvis to the leg. This ball-and-socket design makes it 1 of the most mobile joints in the body, and highlights its critical role in our ability to move and walk. Hip fractures are breaks in the upper part of the thigh bone. They can occur in many areas of the top of this bone, which is also called the femur.

The most common hip fracture is called an intertrochanteric fracture. Intertrochanteric fractures occur in a specific portion of the bone between 2 bony projections on top of the femur, called the greater and lesser trochanters. Hip fractures are common, with over 10 million occurrences per year worldwide. Over 70% of hip fractures occur in females, with more than 40% of fractures occurring over the age of 85. Given the aging population, it is projected that the total number of hip fractures is expected to double by 2050.

Hip fractures can occur in both the young and the elderly, but the causes tend to differ between the 2 populations. In young patients, car accidents and other high-energy traumas are likely to be the cause. In older patients, falls on the side of the hip, which are considered low-energy traumas, are often to blame. Older patients suffer risk factors that make them more likely to sustain these injuries. One of these risk factors is osteoporosis, which directly impacts the quality and strength of the bone.

Other risk factors can make falls more likely, such as poor vision, medication side effects, or decreased mobility. Controlling these risks and preventing falls are key. A hip fracture causes severe pain in the hip, often centered around the groin or thigh. Bruising or swelling may be seen. Deformity of the leg may be noted. It may be shorter or rotate outwards. Sometimes fractures are small and are harder to detect. These are called occult fractures.

In this situation, deformity or rotation may not be seen, and pain with the motion of the leg may be the only symptom. In either situation, difficulty with weight-bearing will follow. If these symptoms have occurred, immediate assessment in the emergency room is warranted. A hip fracture is diagnosed with a series of x-rays. A CT scan is commonly ordered to classify the fracture type and assist the surgical team in planning treatment.

An MRI may be considered if a hip fracture is suspected but not seen on x-rays, such as in an occult hip fracture. Twenty to 60% of patients who fracture their hip will have other medical complications as a result. Thus, following the diagnosis of a hip fracture, a multidisciplinary team will carefully formulate the best treatment plan for each patient.