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Articles from prior issues of The Advocate
May/June, 1998
| Hip Fractures from Mayo Clinic Health Letter, May 1998 IT WAS SUCH A SIMPLE accident. After breakfast, Helen went into the bedroom to get dressed. As she was putting on her pants, she lost her balance, got her feet tangled and fell. When she tried to get up, she felt a sharp pain in her hip. Her husband called an ambulance, and later that day Helen was in surgery to repair a fractured hip. Hip fractures occur in more than 250,000 Americans each year. Over the next 50 years, as the population ages, the number of hip fractures in the United States is expected to double. Fortunately, surgery to repair a hip fracture is usually very effective, although recovery often requires time and patience. Serious, but treatable A hip fracture is a serious injury. Although the fracture itself is treatable, complications can be life-threatening. In fact, the death rate within one year of a hip fracture ranges from about 15 percent to 35 percent. The increased death rate is generally attributed to the fact that hip fractures often occur in people of advanced age who have other serious health problems. If complications occur, these other health problems can make recovery more difficult. However, most people - even those over age 80 - make a good recovery from a hip fracture. Generally, the better your health and mobility, the better your chances for a complete recovery. Several surgical options When a hip fracture occurs, surgery is almost always the best way to repair it. Non-surgical alternatives, such as traction, are typically used only if you have a serious illness that prevents you from having surgery. The risk of traction is that it keeps you immobile for a long period, during which you can develop bedsores, blood clots, a urinary tract infection, pneumonia or other serious complications. The type of surgery you have is generally dependent on the part of the hip that fractured, the severity of the fracture and your age. Ninety percent of fractures occur in either: *The Femoral Neck - The femoral neck is located in the upper portion of your femur, just below its head (the ball part of the ball-and-socket joint). There are three ways to repair this type of fracture. If following the break the bone is still properly aligned, metal screws may be inserted into the bone to hold it together while the fracture heals this is called internal fixation. If, on the other hand, the ends of the broken bone aren’t properly aligned or they’ve been damaged, the head and neck of the femur may be removed and replaced with a metal prosthesis. This is known as hemi-arthroplasty. The third option is total hip replacement, which includes replacing your upper femur and the socket in your pelvic bone with a prosthesis. Total hip replacement is most often performed if arthritis or a prior injury has damaged the joint, affecting its function prior to the fracture. In general, for fractures where bones are not well-aligned, the older you are the more likely you are to receive a prosthesis. Internal fixation is used more in younger people. *The Intertrochanteric Region - These fractures occur in the portion of your upper femur that juts outward - the intertrochanteric region. To repair this type of fracture, a metal screw (a compression hip screw) is inserted across the fracture. Attached to the screw is a metal shaft that runs down alongside the femur to help keep the bone stable. As the bone heals, the screw allows the bone pieces to compress so the edges grow together. Getting back on your feet Remaining inactive and in bed following hip surgery can increase your risk for serious complications, including the development of blood clots, and infection. For that reason, you’ll be assisted in getting up and around as soon as possible. On the first day you’ll likely be moved to a sitting position in a chair. You may even stand or walk a little. Most people who were able to walk prior to a hip fracture are on their feet again within a couple of days. Hospital stays following hip fracture surgery generally last about a week. Afterward, you may continue to meet with a physical therapist. The goal of rehabilitation is to help you regain mobility. You’ll learn how to gradually place more weight on your hip until it can handle your full weight without pain. You’ll also learn how to sit, stand and walk so you don’t re-injure your hip or damage your prosthesis, if you have one. Following a hip fracture you’ll need the help of a walking aid, such as a cane, walker or crutches, for several months. Most people also need assistance getting around their home and doing daily tasks, such as bathing, dressing and cooking. About 50 percent of people over age 65 who break a hip enter an extended care facility while recuperating because they need assistance that’s unavailable at home. Recovery can take up to a year. Unfortunately it doesn’t always result in the same level of mobility you had before the fracture. Think positive More than half of people who experience a hip fracture are able to return
to their previous level of mobility. You can help speed the healing process
and increase your chances for a full recovery by following your doctor’s
and therapist’s instructions and taking good care of yourself. |
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