Hip Fracture Treatment

What is a Hip Fracture?

A hip fracture is a condition in which the bones around the hip joint are damaged. This joint is one of the main load-bearing structures in our lower body and is located between the femur (thigh bone), the largest bone in our leg, and the hollow structure in our pelvis (pelvic bone) called the acetabulum. The hip joint is a “ball and socket” shaped structure at the junction of these two bones. The round head at the top of the femur fits into the hollow part of the pelvis called the acetabulum.

Hip fractures usually occur in the upper part of the femur. This region is divided into the femoral head, femoral neck, and intertrochanteric region (the area between the greater and lesser trochanter). Additionally, the subtrochanteric region just below the greater trochanter is one of the areas where hip fractures may occur.

Types of hip fractures vary depending on the location of the damage and how the bone breaks. The most common of these fractures are:

Femoral Neck Fractures: These fractures occur in the upper part of the femur, in the narrow part between the femoral head and the body. It is a type of fracture that is frequently encountered in the elderly as a result of falls.

Intertrochanteric Fractures: These are fractures that occur in the part of the femur between the greater and lesser trochanters. These fractures usually affect a larger area and their treatment may differ compared to femoral neck fractures.

Subtrochanteric Fractures: They occur in the upper part of the body of the femur, just below the trochanter region of the femur. It usually occurs as a result of severe trauma.

Treatment of each type of hip fracture varies depending on the location of the fracture, its severity, and the patient’s general health condition. Treatment methods may include surgical interventions, fixation with plates and screws, or prosthetic applications. Especially in elderly patients, the treatment of hip fractures and the subsequent rehabilitation process are of great importance, as these fractures can seriously affect mobility and reduce the quality of life.

Types of Femur Bone Fractures

Femur bone fractures are defined as damage to the femur, the largest and strongest bone in our body. These fractures usually occur as a result of high-energy trauma and can be divided into four main categories near the hip joint: femoral head fractures, femoral neck fractures, intertrochanteric fractures, and subtrochanteric fractures. Each type of fracture requires a separate treatment approach depending on where it occurs and its characteristics.

Femoral Head Fractures:

• It occurs at the femoral head, located at the top of the femur, within the hip joint.
• These fractures are generally seen at low frequency and usually occur as a result of high-energy impacts.
• Femoral head fractures can be displaced or nondisplaced (in situ), and this determines the treatment approach.
• The risk of interruption of blood flow is high in these fractures, which can increase the risk of necrosis of the femoral head.

Femoral Neck Fractures:

• It occurs in the narrow area connecting the femoral head and the femoral body.
• It is frequently seen with falls in the elderly and may be displaced or nondisplaced.
• The risk of impaired blood flow is also significant in these fractures, which can make healing difficult and increase the risk of necrosis.

Intertrochanteric Fractures:

• It is located between the protrusions of the femur called the greater and lesser trochanters.
• These fractures, which generally affect a larger area, can be displaced or non-displaced and sometimes lead to multipart fractures.

Subtrochanteric Fractures:

• It is seen in the upper part of the trunk, just below the trochanter area of ​​the femur.
• It accounts for a smaller percentage of hip fractures and usually occurs as a result of severe trauma.

Treatment for each type of femur bone fracture varies depending on the location and type of fracture and the patient’s overall health. Methods such as surgical interventions, plate and screw applications, nail insertion or prosthesis placement can be used in treatment. Especially in elderly patients, the treatment of femur fractures and the subsequent rehabilitation process are of great importance in terms of preserving the patient’s general health and mobility.

What are the Symptoms of Femur Bone Fracture?

Femur bone fractures are serious injuries to one of the body’s largest and strongest bones. Although the symptoms of such fractures are usually sudden and obvious, sometimes milder and slowly developing symptoms can also be observed. Femur fracture symptoms include:

Inability to Walk or Walking with Difficulty:

• Extreme pain and weakness in the leg due to the fracture can make walking difficult or impossible.

Severe Pain in Thigh and Hip Area:

• Intense pain is felt in the area where the fracture occurs. This pain is usually concentrated in the thigh, hip and groin area.

Spread of Pain Throughout the Leg:

• Pain may radiate from the fracture area to the knee and leg.

Increased Discomfort While Moving:

• Increased pain and discomfort during movements such as rotating the hip.

Bruising and Swelling:

• Bruising, swelling and sometimes increased temperature may be observed in the fracture area.

Visible Shortening or Deformation of the Leg:

• Depending on the severity of the fracture, the affected leg may appear shorter than the other or be in an abnormal position.

Abnormal Position of Foot and Knee:

• The foot or knee of the broken leg may be at an abnormal angle, either outward or inward.

Weight Bearing Difficulty:

• It may become difficult or impossible to put weight on the broken leg.

In femur fractures, symptoms are often quite severe. However, in some cases of mild fractures or cracks, the symptoms may be less severe and may present as only mild pain or discomfort. Therefore, it is important to seek medical help without delay in suspicious cases. Particularly in the elderly and people with osteoporosis, femur fractures can occur even with milder injuries or falls and require careful evaluation.

What Causes Femur Bone Fracture?

Femur fractures occur when the thigh bone is damaged and usually occur as a result of serious trauma. The causes of these fractures vary according to age groups and individual health conditions. There are two main groups of causes: high-energy traumas and low-energy traumas.

High Energy Traumas:

• It is more common in young and middle-aged individuals.
• Serious accidents such as traffic accidents, sports injuries, and falls from height are the main causes of these fractures.
• It can also occur as stress fractures among athletes, especially during high-stress sports such as running and athletics.

Low Energy Traumas:

• It is more common in the elderly.
• Weakening of bones due to osteoporosis can cause even simple falls to lead to serious fractures.
• Simple traumas such as domestic accidents, trips and falls, or slips in the bathroom can lead to serious consequences due to weakened bone structure.

Bone Resorption (Osteoporosis):

• It is characterized by decreased bone density and quality.
• It is more common in the elderly and especially in postmenopausal women.
• The decrease in estrogen hormone causes women to lose bone density more quickly, which is one of the reasons why hip fractures are more common in women.

Other Risk Factors:

• In the elderly, factors such as balance and gait disorders, dizziness, vision problems and side effects of some medications increase the risk of falling and thus increasing the risk of femur fracture.
• Some chronic diseases and long-term inactivity can also negatively affect bone health and increase the risk of fractures.

In summary, femur fractures can lead to serious health problems in both young and old individuals, and the causes of these fractures depend on many factors such as age, gender, general health status and lifestyle. Therefore, it is of great importance to take fall prevention measures and bone health supportive measures, especially in individuals at risk.

Hip Fracture Treatment

Treatment of hip fractures varies depending on the type of fracture and the patient’s general health condition. The first step of treatment is to make a correct diagnosis by an Orthopedics and Traumatology Specialist.

Diagnostic Process:

• Diagnosis usually begins with a physical examination and x-ray images.
• If the fracture cannot be detected by x-ray, advanced imaging techniques such as MRI (Magnetic Resonance) or CT (Computed Tomography) can be used.

Treatment Options:

• Treatment is individualized based on factors such as the patient’s age, health status, and type and location of the fracture.
• In some cases, especially in mild or unstable fractures, non-surgical treatment methods may be preferred. These methods include rest, pain management and physical therapy.

Surgical treatment:

• Surgical intervention is often preferred in severe or unstable fractures.
• Surgical options may include plate and screw fixation, intramedullary nail application, or hip prosthesis placement depending on the fracture condition.
• Surgery allows the fracture to heal better and, in some cases, helps the patient mobilize faster.

Is Non-Surgical Treatment Possible?

• Mild and stable femur fractures can sometimes be treated without requiring surgical intervention.
• In this case, limiting the patient’s mobility, managing pain and physical therapy practices come to the fore.
• However, this approach is generally preferred in young and healthy individuals or in very old patients with high surgical risk.

Rehabilitation:

• Hip fracture treatment is completed with postoperative rehabilitation.
• The rehabilitation process is critical for the patient to be able to walk again, return to daily activities and regain muscle strength.

Since each patient’s situation is different, your doctor’s recommendations are essential in determining treatment options. The patient’s lifestyle, general health status and response to treatment form an important part of the treatment plan.

Non-Surgical Treatment for Femur Bone Fractures

Nondisplaced femur fractures can be treated without surgery in some cases. This approach is generally preferred when the patient is not suitable for surgical intervention. The main purpose of non-surgical treatment methods is to support the natural healing process of the fracture and preserve the patient’s functional mobility.

Rest cure:

• In nondisplaced femur fractures, bed rest may be recommended to the patient initially.
• In this process, the aim is to ensure that the fracture remains stable and to support healing.

Risks of Inactivity:

• Prolonged bed rest can lead to additional health problems, such as pneumonia, deep vein thrombosis, muscle weakness, and pressure sores, especially in older patients.
• Therefore, the duration and intensity of bed rest must be carefully managed.

Radiological Follow-up:

• During the non-surgical treatment process, the condition of the fracture and the healing process are closely monitored with regular x-ray checks.
• This follow-up is important to evaluate whether the fracture is healing and whether there is any displacement.

Physical therapy and rehabilitation:

• The patient can be included in a physical therapy and rehabilitation program after bed rest.
• This process is critical for regaining muscle strength, increasing range of motion, and returning to daily activities.

Surgical Treatment Evaluation:

• Non-surgical treatment may not always be the best option. By evaluating the patient’s condition and the course of the fracture, surgical intervention can be performed if necessary.

Every patient and every fracture is unique, so treatment options must be tailored to the individual situation. The recommendations of the Orthopedics and Traumatology specialist are made by taking into account the patient’s general health condition, lifestyle and characteristics of the fracture. The success of the treatment process depends on a combination of accurate diagnosis, appropriate treatment selection and effective rehabilitation programs.

Hip Fracture Surgery

Hip fracture surgeries vary depending on the type, location, degree of fracture and the general health condition of the patient. The aim of the surgery is to stabilize the fracture, reduce pain, and allow the patient to return to daily activities as soon as possible. Here are some basic surgical methods used in these surgeries:

Internal Fixation:

• This method is especially preferred in non-displaced or minimally displaced fractures.
• The fracture ends are fixed using metal plates, screws or intramedullary nails.
• Surgery supports the natural healing process by keeping the fracture fragments in the correct position.

Total or Partial Hip Replacement Surgery:

• This method is especially preferred in elderly patients and femoral head or neck fractures.
• In cases of serious fractures or blood flow disorders in the femoral head or neck, the damaged bone fragments are removed and replaced with a prosthesis.
• A total hip replacement includes both the femoral head and the acetabulum (the socket part of the pelvis), while a partial hip replacement is applied only to the femoral head.

Hemiarthroplasty (Semi-Prosthesis) Surgery:

• This surgical procedure is generally performed on elderly patients and femoral head fractures.
• This method, in which only the femoral head is replaced with a prosthesis, ensures the protection of the other part of the hip joint.

Reconstructive Surgery:

• In multicomponent or complex fractures, the fracture fragments may need to be reattached and fixed.
• The selection of these surgical methods is made according to the type of fracture, the patient’s age, general health condition and postoperative recovery expectations. After surgical treatment, a comprehensive rehabilitation program is required for the patient to recover and regain functional mobility.

Because each patient is unique, the treatment plan and surgical options must be evaluated on an individual basis.

What is the Recovery Process After Hip Fracture Surgery?

The recovery process of patients after hip fracture surgery varies depending on the type of surgery and the general health condition of the patient. This process includes regaining the ability to walk, returning to daily activities, and improving general health status.

Recovery After Hip Replacement Surgery:

• After hip replacement surgery, patients can usually begin walking with light support the day of surgery or the next day.
• At first, activities such as walking with support, sitting, standing and using stairs should be done carefully.
• The patient can be discharged from the hospital after successfully completing these basic movements and having his general health condition evaluated.
• Throughout the recovery process, physical therapy and rehabilitation sessions are important. This is necessary to increase mobility, improve muscle strength and control weight.
• It usually takes 8-10 weeks for patients to fully return to their daily lives.

Healing After Internal Fixation with Plate, Screw or Nail:

• The recovery period after such surgeries usually varies between 8-12 weeks.
• In the initial stages, patients can walk with partial load on the operated leg.
• In the following weeks, with the doctor’s recommendation, the load is gradually increased and normal walking is achieved.
• Physical therapy and rehabilitation also play an important role in this process. The goal is to strengthen the surgical area and increase flexibility.

With both types of surgery, the patient’s general health, age, and any other medical conditions may affect the healing process. Therefore, following the doctor’s recommendations and physical therapy program is critical for the recovery process to be successful. In the postoperative period, it is important to check patients regularly and apply additional treatment approaches when necessary.

What Happens If a Hip Fracture Is Untreated?

Hip fractures are serious health problems, especially common in the elderly, and if left untreated, can lead to serious complications. Problems that untreated hip fractures can cause include:

Loss of Mobility:

• Untreated hip fractures cause pain and limitation of movement over time. This condition can severely limit the patient’s ability to walk and move.
• Over time, patients’ mobility may decrease further and they may become bedridden.

Chronic Pain and Discomfort:

• When the fracture does not heal, constant pain and discomfort may be experienced. This may negatively affect the patient’s quality of life.

Increased Risk of Complications:

• Untreated fractures can become more complicated over time. This increases the risk of complications in subsequent surgical interventions.
• Lack of proper healing at the fracture site can lead to malunion of bones or joint deformities.

Additional Health Problems:

• Prolonged inactivity can cause additional health problems such as pneumonia, deep vein thrombosis, and pressure sores.
• Especially in the elderly, this can lead to further deterioration of general health and the development of other medical problems.

Bone Necrosis:

• Especially in femoral head fractures, disruption of blood flow can lead to death (necrosis) of bone tissue. This condition can cause permanent loss of joint functions.

For these reasons, it is important for patients diagnosed with hip fracture to begin appropriate treatment as soon as possible. Early intervention reduces the risk of complications and has protective effects on the patient’s quality of life. Treatment should be customized according to the patient’s general health condition, age and type of fracture, and should aim to achieve the best possible outcome.

What are the complications after hip fracture surgery?

Although hip fracture surgeries are vital interventions, various complications may occur in these surgeries, as in all types of surgical procedures. Being aware of these complications is important for early diagnosis and intervention. Here are some common complications that may occur after hip fracture surgery:

Non-Union or Delayed Healing of Fractures:

• After internal fixation surgeries, in some cases, femur bone fractures may take longer to heal than expected or may not heal completely.

Infection:

• As with any surgical procedure, there is a risk of infection after hip fracture surgery. The infection rate usually varies between 1-4%.

Avascular Necrosis:

• Especially in displaced femur fractures, bone tissue may be damaged and necrosis (tissue death) may occur as a result of impaired blood supply to the femoral head.

Shortening of Femur Length:

• In femoral neck fractures, a shortening of the femoral length may be observed during the healing process of the fracture.

Mortality (Death) Risk:

• The risk of mortality increases after hip fracture surgery, especially in elderly patients. Studies show that mortality rates increase in the hospital and within one year after surgery.

Early intervention can reduce the risk of postoperative complications. Therefore, in case of femur bone fractures, it is recommended that the patient undergo surgery as soon as possible, in accordance with his general health condition. Thanks to modern treatment methods, advanced implants and technological advances, these risks are significantly reduced.

If you are concerned about your hip health or are experiencing problems such as osteoporosis or hip pain, you should definitely consult a specialist. You can get more detailed information about your condition by showing your imaging results such as X-ray or MRI to your doctor. Remember, early diagnosis and correct treatment play a critical role in preventing such complications and faster recovery.