A hip fracture is a common injury in the femoral (upper thigh) region characterized by acute pain and loss of mobility. The long-term effects of a hip fracture can be detrimental if left untreated.
Hip fractures are typically classified as one of two types: femoral neck fractures, which occur near the hip joint, and intertrochanteric fractures, which occur between the neck and the long femoral shaft. The type of hip fracture you experience will dictate intervention and treatment options.
The majority of hip fractures are a result of a fall or excessive trauma, with the elderly population facing the highest risk of hip fractures due to weakened bones (osteoporosis) and other health complications. A ground-level fall is often all it takes for a frail hip to fracture, and excessively brittle bones might break without a fall occurring.
Though hip fractures are far less common in younger populations, they can still happen from excessive trauma events, such as a car crash or a fall from a ladder. Stress-inducing sports-related movements like running can also lead to a hairline fracture.
Women are at a higher risk of suffering from hip fractures due to less bone mass compared to men. The same is true for those with a low body mass index.
Medications with side effects like drowsiness and dizziness can also increase the risk of a fall-related hip fracture, and those who have dealt with a hip fracture before face an increased risk of a repeat occurrence.
A hip fracture will almost always lead to immediate pain, which is usually localized to the thigh, groin, and hip region. Victims may have a hard time putting any weight on the area, and standing may not be possible.
The upper thigh region will lose flexibility, but the lower leg region should still move normally. The affected area may also be bruised, and the injured leg may look shorter or appear to be rotated inward or outward.
There are many ways to reduce the chances of experiencing a hip fracture. Nutrition is perhaps the most vital prevention method, including the intake of calcium-rich foods and plenty of Vitamin D. Other healthy habits that can make a positive difference include minimizing alcohol and abstaining from smoking.
Those living sedentary lifestyles increase their risk of suffering from a hip fracture. Regular exercise and a muscle strengthening routine, including consistent walks, is crucial in hip fracture prevention.
Elderly folks must be even more mindful of their everyday habits, including limiting hazards around the house. Slip-resistant rugs, handrails for stairs and showers, and proper lighting are all vital in keeping an environment safe and minimizing fall risk.
Older populations may also consider a cane or fall-resistant device such as a walker to add stability. A bone density test can also give insight into osteoporosis risk, which may allow for early medical intervention to minimize bone density loss.
If you suspect you or a loved one has suffered from a hip fracture, consult a physician right away. An exam will allow a medical professional to assess the severity of your injury by observing circulation, movement, and sensation in the affected area. An X-ray will usually be sufficient in diagnosing a hip fracture, though a CT scan or MRI may be used to get a better look at the injury.
Non-surgical
Most hip fractures will require surgical intervention, though it may not be in the best interest of older, at-risk patients. Non-surgical intervention will yield a much slower recovery process, with a minimum of several weeks of non-weight-bearing activities required. In these rare cases, the focus will be on pain management and quality of life versus the expectation of a full recovery.
For non-surgical and surgical victims alike, over-the-counter medications like NSAIDs (non-steroidal anti-inflammatory drugs) are recommended to manage pain. In some cases, your physician may write you a prescription.
Surgical
Most hip fractures will require surgical intervention, which will usually take place within 24-48 hours of diagnosis. The procedure will depend on where the fracture occurs within the femoral region.
The most common procedures involve screws, plates, and rods to stabilize the fracture and promote healing. Severe hip fractures may require a partial or full hip replacement (prostheses). A partial hip replacement will involve the replacement of the upper femur, and a full replacement will necessitate the socket be replaced as well.
Post-surgery intervention will vary depending on the patient’s overall health. Most younger patients can recover at home, while older patients may require closer care in a rehabilitation facility. Physical therapy will be a crucial step in the recovery process regardless of age and setting.
Physical Therapy
At Hicksville Physical Therapy, we will assess your hip situation to formulate a plan, accounting for factors such as your medical background and goals for recovery.
Most patients should be able to get out of bed within a day or two of surgery, then the physical therapy rehabilitation process can begin. Pushing yourself to stand and regain mobility will allow you to maintain most of your pre-injury strength and minimize issues like sores and clots that often occur when bedridden.
Once we’ve set expectations regarding your recovery, we will work with you on regaining mobility with gradual weight-bearing activities. We will also assist you in developing a safe plan to carry out daily tasks like dressing and showering while you recover.
The exercise portion of rehabilitation will focus on progressive resistance movements that will allow you to rebuild strength. If you are healthy enough to rehab at home, we will ensure you understand the exercises well enough to perform them on your own.
One simple yet effective exercise is the straight leg raise, which engages the hip flexors and quadriceps. To conduct this exercise, you will lay on your back with your legs straight, then slowly lift the affected leg off the ground before returning it to the floor. Ten repetitions three times each day is sufficient for this exercise.
Hip abductions are another great exercise to enhance hip stability and strength. Much like the straight leg raise, you will start by laying on your back with your legs extended straight, but this time, you will lift your leg outward before returning it to the starting position. You can also target ten repetitions of this exercise three times per day.
We will routinely reassess your pain level during exercises and while at rest to ensure healing without setbacks. We may also conduct strength tests using tools like a dynamometer to ensure you are on the right track. Most patients report feeling much more like themselves by 8-16 weeks.
For more information about hip fracture treatment options in Long Island, contact Hicksville Physical Therapy today.
