What is a Broken Hip?

Hip fractures are breaks in the upper femur or thighbone, just below the hip joint. Hip fractures are very common, especially in the aging population. Most require hospitalization and surgery. Women are more susceptible to hip fractures than men.
How Serious is a Broken Hip?

Although modern care and technology assist with bone healing, most hip fracture patients require extended periods of rehabilitation. Most hip fracture patients who previously lived independently will require assistance from their family or home care. All hip fracture patients require walking aids for several months after injury, and nearly half will permanently require canes or walkers to move around the house or outdoors.

Who is at Risk?

Common characteristics of people who are at risk:

  • Age: the rate increases for people 65 and older
  • Gender: women have two to three times as many hip fractures as men
  • Heredity: family history of fractures in later life • small-boned, slender body
  • Nutrition: low calcium dietary intake or reduced ability to absorb calcium
  • Personal habits: smoking or excessive alcohol use
  • Physical impairments: physical frailty, arthritis, poor balance and co-ordination, poor eyesight Mental impairments: senility, dementia (ie. Alzheimer’s disease)
  • Medications: weakness or dizziness due to adverse side effects of medication

Why Do Broken Hips Occur?

The upper femur in young people is one of the strongest bones in the body. With aging and disease, the upper femur weakens and becomes vulnerable to a fracture.

Why Do Bones Weaken?

Bone is a living tissue, composed mainly of calcium and protein. Bones with high calcium content are strong. Healthy bone is always being re-modeled. That is, small amounts are being replaced. If more bone calcium is absorbed than is replaced, the density or the mass of the bone is reduced. This bone becomes progressively weaker, increasing the risk that it may break. Loss of bone tends to occur mostly in the spine, lower forearm above the wrist, and upper femur, the site of hip fractures. Spine fractures, wrist fractures and hip fractures are common injuries in older people. A gradual loss of bone mass, generally beginning about age 35, is a fact of life for everyone. After growth is complete, women ultimately lose 30% to 50% of their bone density, and men lose 20% to 30%.

Women lose bone calcium at an accelerated pace once they go through menopause. Menstrual periods cease because a woman’s body produces less estrogen hormone. Estrogen in women is important for the maintenance of bone mass or bone strength. A measurement of bone density when menopause begins may help women decide whether to use estrogen replacement therapy to retard bone loss.

How to Prevent Broken Hips

Orthopedic surgeons, experts in the care and treatment of patients with fractured hips, are concerned about the epidemic of hip fractures and the impact these severe injuries have on patients, their families, and on society. Orthopaedists know that prevention of hip fractures is far better, and far less costly, than treatment after the bone is broken. Here’s what can be done:

  • Ensure that diet contains the necessary calcium and vitamin D during childhood, adolescence and adulthood. Vitamin D plays a major role in calcium absorption and its incorporation in bone. A doctor may recommend an increase in intake of vitamin D after menopause. Elderly people may consume less vitamin D and absorb calcium poorly. A doctor should be consulted concerning increasing daily intake of vitamin D.
  • Exercise to minimize bone lose. Weight-bearing exercise, such a walking (considered one of the best methods of maintaining bone strength), jogging, hiking, climbing stairs, dancing, aquatic exercises, treadmill exercises and weight training are very important. Consult a doctor before beginning any vigorous exercise program. Doctors will evaluate physical condition and help decide which activities are best. The National Institute of Aging recommends beginning an exercise program slowly, especially if one has been inactive. Starting with short periods of about 5 to10 minutes twice a week and building up slowly, adding a few minutes each week. It is possible to build up to exercise periods of 15 to 30 minutes, three to four times a week.
  • Proper diagnosis and early treatment can help reduce the risks of osteoporosis. A medical doctor will prescribe individual treatment. Treatment plans should be initiated as early as possible. Once bone is lost, it is difficult to replace.Doctors will gladly educate people as to current medications and therapies recommended to prevent menopausal bone loss. A second opinion is always wise.
  • Eliminate smoking and excessive alcohol use which cause bone loss and increase risk for a fracture.
  • Persons requiring medications regularly that can alter balance or cause dizziness should discuss this with their physician. Certain drugs, such as benzdiazepines, that are common treatments for anxiety or insomnia, may cause dizziness and falls.

Make Your Home Safe

Most hip fractures occur as a result of a fall. Most falls and injuries occur in the home. Many are preventable by recognizing the dangers and taking the necessary steps to minimize the risks of preventable falls from known home hazards. Here are some safety tips:

Stairways

  • Light should be sufficient to clearly see each step and the top and bottom landings.
  • Loose stairway rugs or boards should be repaired immediately.
  • Object should not be left on the stairs.
  • Patterned or dark carpeting is not recommended on stairs.
  • Full-length handrails should be installed on both sides of a stairway.

Bedrooms

  • The floor should be kept clear of clutter.
  • There should be a lamp and flashlight near the bed.
  • A night-light should be installed along the route between the bedroom and the bathroom.

Living Areas

  • Furniture should be arranged to provide a clear pathway between rooms.
  • Low-rise tables, magazine racks, footrests and plants should be removed from pathways.
  • Electrical and telephone cords should be out of pathways.
  • Loose area rugs and runners should be secured with double-faced tape, tacks or slip-resistant backing.
  • It should be recommended to clients that they not stand on unsteady stools, chairs, ladders, etc…

Kitchen

  • Spills, dropped food, etc., should be cleaned up immediately.
  • Non-skid floor wax should be used.
  • Step stools with an attached handrail are recommended.

Source: This information was made available through the American Academy of Orthopaedic Surgeons and The Canadian Orthopedic Association.