Why is a Fractured Hip so Dangerous for Seniors?

Published: Last Updated: Category: Hip Pain

A broken hip in elderly people is both common and painful. Because of weakening bones and the onset of medical issues such as osteoporosis or other ailments that limit mobility, seniors can become especially susceptible to breaking a hip as they age.

Learning about preventative measures can help to keep bones strong and decrease the risk of falling and becoming injured. Understanding treatment options and what to expect as a result of sustaining a hip fracture can also be helpful in minimizing pain and making a recovery as efficient as possible.

RISKS OF A HIP FRACTURE IN THE ELDERLY

Falls lead to the vast majority of broken hips in the elderly, so it becomes necessary to understand why falls happen as well as how to prevent them. The following video sheds some additional light on the topic:

 

 

According to the National Institute of Health (NIH), scientists have linked numerous personal risk factors to falling. Some of these factors include:

  • Weak muscles—notably in the legs
  • Poor balance, which can cause difficulty walking and lead to an increased risk of falls
  • Sudden drops in blood pressure when getting up from either sitting or lying down
  • Dizziness that results from postural hypertension
  • Poor vision—not seeing as well as in the past
  • Slower reflexes which can lead to difficulty re-gaining balance

Most of these falls occur in the home for a variety of reasons. A few hazards include clutter, loose rugs, limited access to railings and grab bars, or poor lighting.

SURGERY FOR HIP FRACTURES

Surgery is necessary to repair the break after sustaining a hip fracture. This type of surgery requires general anesthesia or spinal anesthesia. Spinal anesthesia includes injecting medicine into the back to numb the patient below the legs.

The type of broken hip surgery performed will depend on the kind of fracture sustained.

If the fracture has occurred in the neck of the femur, the patient is likely to undergo a hip pinning procedure. To perform this surgery, a doctor will have the patient lie on a table and use an x-ray machine to determine how the parts of the hip bone line up.

The surgeon will make a small incision on the side of the thigh and insert screws to keep the bones stabilized and in their correct position. This procedure typically lasts between 2 and 4 hours.

If the injury is an intertrochanteric fracture, which is the area below the neck of the femur, the surgeon will use a plate and compression screws to repair it.

This procedure is very similar to the one performed when the fracture occurs in the neck of the femur. The only difference being the inclusion of a metal plate in addition to the screws and that the surgery takes less time (2 hours or less).

Full hip replacement surgery may also be necessary if the ball portion of the hip joint was also damaged.

Without undergoing any of these procedures, a person with a broken hip winds up almost entirely confined to a chair or bed due to extreme difficulty in moving around. Bypassing surgical repair is incredibly risky because it can lead to life-threatening medical issues.

POST-SURGICAL COMPLICATIONS

Although it is far riskier to forego surgery to repair a broken hip in the elderly, there are still quite a few risks attached to having a procedure done. Examples of these risks include:

  • Blood clots that may form in the leg veins can break off and travel to the lungs or heart
  • Infections can develop at the incision site and need antibiotics. If the infection is major, it may require additional surgery
  • Other fractures may occur in the healthy portions of the hip joint during surgery

PREVENTING HIP FRACTURES

Seniors who sustain hip fractures are at the highest future risk of suffering another fracture.  Many of these seniors are deficient in vitamin D, and vitamin D supplementation is generally believed to improve bone mineral density and also prevent falls. In addition to vitamin D supplementation, seniors should also look to add supplemental calcium to their daily regimen.

Because such a high rate of hip fractures occur among the elderly who have osteoporosis, addressing the osteoporosis itself is usually a good strategy. Although there is no cure for osteoporosis, these FDA-approved medications are used to treat the condition:

  • Bisphosphonates – These drugs create a reduction in the activity of cells that lead to bone loss
  • Parathyroid Hormone – Approved for post-menopausal women as well as men with osteoporosis and a high probability of having a fracture
  • Calcitonin – Promotes calcium regulation and bone metabolism and is approved for treating osteoporosis in women five years or more beyond menopause
  • Estrogen and hormone therapy – Approved for the treatment of osteoporosis in women after menopause

SOURCES

Content Sources

  • Hip Fractures Among Older Adults, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2016, https://www.cdc.gov/homeandrecreationalsafety/falls/adulthipfx.html

  • Complications of hip fractures: A review, Pedro Carpintero, Jose Ramón Caeiro, Rocío Carpintero, Angela Morales, Samuel Silva, and Manuel Mesa, 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4133447/

  • Hip fracture surgery, ADAM Health Solutions, 2021, https://medlineplus.gov/ency/article/007386.htm

  • In Brief: Fractures in Brief: Intertrochanteric Hip Fractures, Jaimo Ahn, MD and Joseph Bernstein, MD, 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853662/

  • Hip Fracture, Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/hip-fracture/diagnosis-treatment/drc-20373472
  • Hip Replacement, Mayo Clinic, https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042
  • Nerve Blocks, https://www.radiologyinfo.org/en/info/nerveblock

Image Sources

  • https://pharmanewsonline.com/category/featured-news/page/25/

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