Hip Fracture

A hip fracture is a break in the bony structures that make up the hip joint. This joint consists of the spherical head of the femur and the acetabular socket, the part of the pelvic bone where the femoral head fits. Below the femoral neck is a broader region containing the trochanters—two bony protrusions where the leg and gluteal muscles attach. The hip is one of the most important joints, as it enables a wide range of movements and supports body weight, providing stability, weight distribution, and shock absorption.

Depending on the fractured part of the joint, hip fractures are classified into two types:

• Intracapsular fracture: Occurs within the joint capsule, a fibrous sheath lined with synovial membrane that encloses the joint.
• Femoral head fracture: Affects the femoral head.
• Femoral neck or subcapital fracture: A break in the femoral neck.
• Extracapsular fracture: Occurs outside the joint capsule.
• Pertrochanteric or intertrochanteric fracture: The area between the trochanters is fractured.
• Subtrochanteric fracture: The break is located below the lesser trochanter.

Due to its role in the body, a hip fracture is a serious injury that requires specific treatment and has a slow recovery process.

Symptoms

Common symptoms of a broken hip include:

• Severe pain in the hip or groin.
• Referred pain in the knee may occur, as both joints share the same nerve pathways.
• Inability to walk, stand, or move the leg.
• Outward rotation of the injured hip, making the leg appear shorter.
• Swelling and bruising due to blood vessel rupture.
• Dizziness and weakness if bleeding is significant.

Causes

A hip fracture occurs due to trauma, which may result from various factors:

• Falls: Very common in older adults, as they have weaker bones and are more prone to losing balance and falling. In their case, it is often caused by a minor fall while standing or even by turning while bearing weight on one leg.
• Traffic accidents.
• Falls from heights.
• Sports collisions.

Risk Factors

The likelihood of experiencing a hip fracture increases under the following conditions:

• Age: More common in elderly individuals.
• Sex: More frequent in women, as menopause accelerates bone loss.
• Disorders affecting bone density, such as osteoporosis, osteopenia, or hyperthyroidism.
• Calcium and vitamin D deficiency.
• Reckless driving.
• Engaging in high-risk or contact sports.
• Use of sleeping pills, antipsychotics, or sedatives: These may cause dizziness, leading to falls.

Complications

The femoral neck contains arteries that supply blood to the femoral head, so if a fracture occurs, blood flow may be disrupted. Insufficient blood supply can lead to osteonecrosis—the bone cannot heal and eventually dies. This can result in femoral head deformity or arthritis due to joint deterioration.

Additionally, a hip fracture forces the patient to remain in bed for an extended period. The complications of immobility include:

• Loss of muscle tissue and decreased overall physical condition.
• Pressure ulcers: Sores or wounds that develop on the skin due to prolonged immobility. These lesions can cause severe infections.
• Pulmonary embolism: Immobility slows blood circulation and increases the risk of clot formation in the veins. These clots may dislodge, travel through the bloodstream, and block a pulmonary artery.
• Aspiration pneumonia: Eating without an upright posture can cause portions of food, liquids, or saliva to enter the respiratory tract instead of being swallowed, leading to lung and bronchial inflammation due to microorganisms in the food or drink.

Prevention

To reduce the risk of a hip fracture, it is essential to take measures to strengthen bones and prevent falls and accidents:

• Drive cautiously and use necessary safety measures.
• Wear protective gear during sports activities.
• Consume adequate calcium and vitamin D.
• Exercise to strengthen bones and improve balance.
• Avoid slippery surfaces.

Which Doctor Treats Hip Fractures?

Hip fractures are diagnosed and treated in the Traffic Unit, Orthopedic Surgery, and Traumatology departments.