The hip joint is a ball-and-socket joint where the upper end (head) of the thigh bone (femur) joins with the socket (acetabulum) of the pelvis. It allows for motion and gives the stability needed to bear body weight.
The hip is the area located on each side of the pelvis. The pelvis bone is made up of 3 sections:
- Ilium- The broad, flaring portion of the pelvis.
- Pubis- The lower, rear part of the pelvis.
- Ischium- One of the bones that helps form the hip
The hip is one of the most stable joints in the body. As it bears your body weight, it is more likely to develop arthritis because of the extra pressure. Pain in the hip may be caused by injury to muscles, tendons, or the small fluid-filled sacs (bursae) that cushion and lubricate joints.
WHAT IS A HIP FRACTURE?
A hip fracture is a break in the part of the upper part of the femur (thighbone) that happens within the hip joint. There are 4 types of hip fractures, with Femoral neck fracture and Intertrochanteric fracture being the most common type. The 4 fractures are:
- Femoral neck fracture
This is the area of the femur below the femoral head.
- Intertrochanteric fracture
The area below the neck of the femur and above the long part or shaft of the femur, and in between the greater and lesser trochanter.
- Subtrochanteric fracture
The upper part of the shaft of the femur below the greater and lesser trochanters.
- Femoral head fracture
The ball of the femur that sits in the socket.
WHAT ARE THE SYMPTOMS OF A HIP FRACTURE?
If you have fractured your hip, you will experience the following symptoms:
- Severe pain that is localized in your hip, groin or upper thigh, and the pain may become worse when you move.
- Inability to stand, bear weight and move the upper part of your injured leg. However, you can move your ankle and toes.
- Bruising and swelling in and around your hip area.
- The leg at the side of your injured may look shorter and turn outwards.
WHAT ARE THE CAUSES AND RISK FACTORS OF A HIP FRACTURE?
Hip fractures are most common among elderly patients and those whose bones have become weakened by osteoporosis. A simple fall may result in a hip fracture. Other factors include:
- High impact injury such as a fall (landing on your side) or a motor vehicle crash
- Gender (women are 3 times more at risk than men for a hip fracture)
- Endocrine disorders such as thyroid leads to weaker bones
- Lack of physical activity (lack of exercise and being unfit increases your chances of getting a hip fracture)
- Smoking and alcohol consumption
- Being underweight
WHAT IS THE DIAGNOSIS OF A HIP FRACTURE?
A history of the injury and a physical examination will be conducted by the Doctor. The doctor will check on the sensation, movement, and circulation in your lower leg.
Imaging tests such as an x-ray of the injured hip will be taken to show the fracture. If required, a second X-ray or MRI scan may be taken to confirm the diagnosis.
WHAT ARE THE TREATMENT OPTIONS FOR A HIP FRACTURE?
For most cases, the ideal treatment for a hip fracture is surgery, as surgery gives the best chance of walking again. The only time when nonsurgical treatment is considered is when the patient is suffering from serious illnesses and doing surgery will create complications which will put the patient at risk.
For surgery, the type of operation will depend on your age, type of fracture, and how active you are. Types of surgical treatment include:
- Internal repair using screws
Metal screws are being inserted into the bone so as to hold the pieces together while the fracture heals. In certain cases, screws are attached to a metal plate that runs down the femur.
- Total hip replacement
In a total hip replacement, your upper femur and the socket in your pelvic bone are replaced with artificial metal parts (prostheses). Total hip replacement has shown to be more cost-effective and associated with better long-term outcomes in healthy adults who live independently.
- Partial hip replacement
If the ends of the broken bone are displaced or damaged, your doctor may decide to do a partial hip replacement and remove the head and neck of the femur, replacing it with a metal replacement. Partial hip replacement might be recommended for adults who have other health conditions or are unable to live independently.
Should the blood supply to the ball part of your hip joint be damaged during the fracture, it is recommended to do a total or partial hip replacement.
WHAT IS THE RECOVERY PROCESS AFTER A HIP FRACTURE SURGERY?
After surgery, physiotherapy will be recommended. This will start immediately on the next day after your surgery. Physiotherapy will help you to regain your muscle strength and restore your range of motion, and help you get back on track. Depending on your condition, you may need a walker or wheelchair to help you regain mobility.