An elderly person experiencing a hip fracture will likely find walking impossible or very difficult. Attempting to do so can be dangerous. This injury is serious for older adults and requires immediate medical attention. The general expectation is an inability to bear weight.
Understanding Hip Fractures in Older Adults
A hip fracture involves a break in the upper part of the thighbone (femur), near its connection to the pelvic bone. The hip joint functions as a ball-and-socket, where the rounded top of the femur fits into the pelvis. Fractures can occur in various areas of the upper femur, with femoral neck and intertrochanteric fractures being among the most common types.
Hip fractures are particularly prevalent in older adults, with over 300,000 cases annually in the U.S. among individuals 65 or older. This vulnerability is primarily due to osteoporosis, a condition characterized by reduced bone density that makes bones porous and brittle. As bone density and muscle mass decrease with age, older individuals are more susceptible to falls, which are the most common cause of hip fractures. Even a minor fall or twisting injury can cause a fracture in bones compromised by osteoporosis.
Identifying a Hip Fracture
Severe pain in the hip or groin area is a primary indicator, often intensifying with any attempt at movement or weight-bearing. This pain may also radiate to the upper thigh or even the knee.
A person with a hip fracture typically cannot stand, bear weight on the affected leg, or move the upper part of their leg. The injured leg may also appear shorter than the uninjured one and often turns outward at an unusual angle. Swelling and bruising around the hip area can also develop, sometimes appearing several hours or days after the initial injury. While most hip fractures prevent walking due to pain and instability, some non-displaced fractures, where bone pieces remain aligned, might allow for limited movement with mild pain, but this is less common.
Emergency Response and Treatment
If a hip fracture is suspected, call for emergency medical assistance immediately. Keep the person still and comfortable while waiting for help. Medical professionals diagnose hip fractures using imaging techniques like X-rays. If X-rays are inconclusive but a fracture is suspected, a CT scan or MRI may be used for a more detailed assessment.
Treatment for a hip fracture almost always involves surgery. The type of procedure depends on the fracture’s location and severity, and the patient’s overall health. Common surgical options include internal fixation, using pins, screws, plates, or rods to hold broken bone fragments together. Another approach is hip replacement, which can be partial (replacing only the ball of the thighbone) or total (replacing both the ball and the hip socket). Hip replacement is often considered when the blood supply to the femoral head is compromised or if internal fixation is less suitable, particularly in older patients.
The Path to Recovery
Recovery following a hip fracture is extensive, aiming to regain mobility and independence. Rehabilitation begins soon after surgery, often while the patient is still in the hospital. Physical therapy is a major component, focusing on restoring strength, improving range of motion, and teaching safe mobility techniques, such as using walkers or canes. Therapists guide patients through exercises to strengthen hip and leg muscles and improve balance.
Occupational therapy also plays a significant role, helping patients relearn daily activities like dressing, bathing, and preparing meals. These therapists assess how the fracture impacts a person’s ability to perform routine tasks and develop strategies to adapt those skills. Recovery can take several months. Challenges include persistent pain, emotional distress such as fear of falling again, and a potential decline in overall function, especially for those with pre-existing cognitive impairments. Support systems, including family and caregivers, are important in assisting with rehabilitation and ensuring a safe return home.
Strategies for Prevention
Preventing hip fractures in older adults focuses on reducing fall risk and maintaining bone health. Environmental modifications at home can lower fall risks. This includes removing tripping hazards like loose rugs and clutter, ensuring adequate lighting, and installing grab bars in bathrooms and handrails on staircases.
Regular physical activity is important for strengthening muscles and improving balance, which helps prevent falls. Exercises like walking, jogging, or tai chi contribute to better strength and balance. Maintaining strong bones through adequate nutrition is another preventative measure. This involves consuming sufficient calcium and vitamin D, essential for bone density. The recommended daily intake for adults over 65 is around 700-800 mg of calcium and 400-800 IU of vitamin D, achievable through dairy products, fortified foods, and sunlight exposure. Regular medical check-ups help monitor bone density and address underlying health conditions that might increase fracture risk.