Why are hip fractures so common in elderly people?The cause is not known. Many patients will say that they sustained the fracture by falling, stumbling or tripping. There is a high probability that the fracture occurred first and the individual fell, stumbled or tripped because of it. Patients have been known to turn over in bed and fracture a hip. Hip fractures have a direct correlation with stresses and strains associated with alteration in the bone structure and blood supply associated with aging.
On home consultation, how can you be so sure, without an X ray, that the hip is fractured?Home consultation can show the characteristic deformity of a fractured hip. The ankle is turned out; on direct measurement this leg is now shorter than the opposite one; there is severe pain in the groin and on motion of the hip; and the heel cannot be raised off the bed. An X ray of course is still necessary, for it is possible to have a fractured hip in which these obvious signs are not present.
Is it possible to have a fracture without pain?It would be most unusual. Where it occurs, the bone was probably diseased before the fracture took place. Thus a patient may get a fracture through a bone that has a tumor in it. This kind of fracture may be painless.
Is there any way of preventing a hip fracture?None at all. One cannot limit one's activity in any way as an anticipatory method of avoiding a fracture in this area.
She is so old, why don't we just do nothing?Some fractures of the hip will heal even if nothing is done surgically. But while lying in bed the individual may get other very serious complications. If the patient was walking before the fracture, then the fracture is worth fixing. The risk of the operation is far less than the risk of doing nothing. It is more humane to do something than to neglect the problem and see the patient become increasingly confused and incontinent, get bedsores, and take a chance on pneumonia. With rare exceptions one is strongly advised to treat this fracture aggressively. With no other fracture has it been so poignantly demonstrated that the patient and the fracture must be treated simultaneously.
What is the best treatment?The usual hip fracture requires an operation as quickly as possible after the patient is in good general health. While not an emergency in the strict sense of the word, the operation should be done promptly. It is urgent" not only because of pain but also because lying immobile in bed can lead to congestion of the lungs, which in time can lead to pneumonia and other complications. By operating promptly, the pain is relieved and the patient can be mobilized.
What are the complications if the operation doesn't go well?There are a number of possible complications. The hip bone (femur) has a cup shape that fits into a socket in the side of the pelvis. This is a ball and socket joint. The ball may disintegrate because it doesn't have a proper supply of blood. The socket may be so damaged that arthritis develops. If good approximation of the bony parts is not maintained, the leg may be shortened by as much as 1/2 to 3 inches. Infection is particularly dangerous, although today these hazards have been reduced by improved technology and methodology.
Other complications are those that can accompany any major surgery, particularly in an elderly patient pneumonia, stroke, heart attack, lung embolus, confusion, disorientation and kidney failure.
What is a total hip replacement operation?The operation first removes (actually excises) the entire diseased hip and reams out the diseased cartilage of the joint lining. A prosthetic artificial hip joint is then inserted as a replacement in the exact position of the removed part. The point consists of a round metal socket placed into the hip as the joint and a stem part that is fixed into the bone of the thigh. This component is held in place by a cement or bonding material such as is used by dentists to keep inlays in place. Thousands of these operations have been satisfactorily performed. The metallurgy and chemistry of the bonding material have played a large role in making them a success.
How long is recovery for hip replacement?Most hip substitution patients can stroll around the same time or following day of medical procedure; most can continue ordinary routine exercises inside the initial 2 to about a month and a half of their absolute hip substitution recuperation. When light action gets conceivable, it's critical to consolidate solid exercise into your recuperation program.
Hip Exercises – After Your Joint Replacement Surgery
At this time total replacement is done primarily as a salvage procedure in patients whose activity is severely limited by painful arthritis of the hip joint. It can completely relieve the pain.
Replacement is also undertaken if the fractured hip is so smashed that no other procedure would be effective. It can also be used as a secondary operation if the first hip operation does not offer the patient a stable, painless hip joint.