• Dr. Sunil Dachepalli

Fractures Around Hip

Description:

Most hip fractures occur in one of two locations in the thigh bone (Femur).

Two places where Hip fractures can occur:

  1. The femoral neck(Neck): This area is located in the upper portion of the femur, just below the ball part (femoral head) of the ball-and-socket. joint.

  1. The Intertrochanteric region(IT): This region is a little farther down from the actual hip joint, in the portion of your upper femur that extended outward.

Symptoms:

  1. Inability to move immediately after a fall.

  2. Severe pain in the hip or groin.

  3. Inability to put weight on the affected side.

Treatment:

Surgical:

The type of surgeries depends on the location and severity of the fracture, whether the broken bones are improperly aligned (displaced fracture), age and the underlying health conditions. Options include:

1.Internal Fixation: Metal screws +/- plates are inserted into the bone to hold it together whilst the fracture is healing. In IT fractures screws are attached to a metal plate (DHS) that runs down the femur. Nails could also be used for fixation.


2.Total hip replacement: The upper femur and the socket in the pelvic bone are replaced with prosthesis. Total hip replacement associated with better long-term outcomes for healthy adults who can live independently.

3.Partial hip replacement: If the ends of the broken bone are displaced or damaged, the top end of the femur is removed and replaced with a metal ball (prosthesis). Partial hip replacement may be recommended for adults who have other health conditions or cognitive impairment or who no longer live independently.

Rehabilitation:

  1. Depends upon the type of surgery:

  2. In case of internal fixation with metal screws and plates, patients are advised not to bear weight for atleast 6 weeks.

  3. In case of Hemi replacement or Total replacement patients will be moved out of the bed the day after surgery.

  4. Range-of-motion and strengthening exercises.

  5. Physiotherapist will teach the techniques for independence in daily life, such as using the toilet, bathing, dressing and cooking.

  6. Physiotherapist will determine if a walker or wheelchair may help to regain mobility and independence.

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