Broken Hip or Femoral Neck Fracture
A broken hip is the common term for a fractured neck of femur, a fracture of the upper thigh bone near the hip joint. This fracture is most common in the elderly population who have a level of osteoporotic changes leading to lowered bone density in the neck of the femur which might fracture on relatively trivial stress.
Hip fractures are a major issue in elderly populations as there is a significant risk of long term reduction in independence and the more frail patients may not survive the process for very long
Broken Hip in the Elderly
After a fall an elderly person with complain of the typical broken hip symptoms of hip pain, inability to walk and perhaps a shortened leg. Broken hip therapy can be conservative if the fracture is impacted (pushed together) and the patient may mobilise with the physiotherapist as hip pain allows. Treatment is hospitalisation and fixation of the fracture with internal metalwork or hip replacement. Hip replacement may be performed if the fracture is very high and likely to have disrupted the blood supply to the head of the femur.
The level of fracture is the important factor in deciding the management for broken hip surgery, also know as ORIF hip (open reduction internal fixation). A fracture of the hip can be just below the head (sub-capital), mid neck, low neck, through the trochanter or through the upper part of the femoral shaft. Surgical management of many of these hip fractures is with the dynamic hip screw which compresses the fragments together and holds the fracture secure until it unites.
There are several types of hip replacement to manage a broken hip including the Austin Moore hip prosthesis, a half hip replacement or hemiarthroplasty. Operations such as hip resurfacing are not suitable for the management of femoral neck fractures.
The costs of a broken hip in the elderly population are very great, as medical care after operation is complex and in some cases includes hip replacement costs, re-operation, rehabilitation, pharmacological treatment and elderly medicine follow up. Only knee replacement may be more expensive due to the high price of the components and the length of the rehabilitation programme, while there seems little need for hip replacement exercises
Recovery From A Broken Hip
Broken hip recovery time varies greatly between individuals, with younger and medically well patients mobilising early with the physiotherapist and being discharged in a few days. Broken hip recovery for frail elderly patients with several medical complications is much more difficult and their broken hip hospital stay can be weeks before they are placed in a residential or nursing home. Many elderly patients never regain their prior mobility nor their independence.
It's a good idea to watch an informative hip replacement video as this makes what is going to go on in the hip much clearer and allows the patient to participate in the rehabilitation with the physiotherapist in a more informed manner.