The hip joint is a “ball and socket” joint. The “ball” is the head of the femur or thigh bone and the “socket” is the cup shaped acetabulum. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint.
Hip fracture is a break that occurs near the hip in the upper part of the femur or thigh bone. The thigh bone has two bony processes on the upper part – the greater and lesser trochanters. The lesser trochanter projects from the base of the femoral neck on the back of the thigh bone. Hip fractures can occur either due to a break in the femoral neck, in the area between the greater and lesser trochanter or below the lesser trochanter.
Hip fracture is most frequently caused after minor trauma in elderly patients with weak bones, and by a high-energy trauma or serious injuries in young people. Long term use of certain medicines, such as bisphosphonates to treat osteoporosis (a disease causing weak bones) and other bone diseases, increases the risk of a certain type of hip fracture. Bisphosphonate treatment is likely best in cycles rather than continuous because of this and other complications of treatment.
Signs and symptoms of hip fracture include
- Pain in the groin or outer upper thigh
- Swelling and tenderness
- Discomfort while rotating the hip
- Shortening of the injured leg
- Outward or inward turning of the foot and knee of the injured leg
Your doctor may order an X-ray to diagnose your hip fracture. Other imaging tests, such as a CT scan or a magnetic resonance imaging (MRI), may be performed to detect the fracture and plan treatment.
Depending on the area of the upper femur involved, hip fractures are classified as
- Intracapsular Fracture
- Intertrochanteric Fracture
- Subtrochanteric Fracture
Hip fractures can be corrected and aligned with non-operative and operative methods:
Traction may be an option to treat your condition if you are not fit for surgery. Skeletal traction may be applied under local anaesthesia, where screws, pins and wires inserted into the femur and a pulley system is set up at the end of the bed to bear heavy weights. These heavy weights help in correcting the misaligned bones until the injury heals.
Hip fractures can be surgically treated with intramedullary fixation, or by using plates and screws. Sometimes partial hip replacement or even total hip replacement is the best treatment for a hip fracture.