Hip fracture
| Hip fracture | |
|---|---|
| Other names | Proximal femur fracture;[1] femoral neck fracture [main hyponym]; femoral head fracture [other hyponym] |
| Intertrochanteric hip fracture in a 17-year-old male | |
| Symptoms | Pain around the hip particularly with movement, shortening of the leg[2] |
| Types | Intracapsular, extracapsular (intertrochanteric, subtrochanteric, greater trochanteric, lesser trochanteric)[1] |
| Causes | Trauma such as a fall[1][3] |
| Risk factors | Osteoporosis, taking many medications, alcohol use, metastatic cancer[2][1] |
| Diagnostic method | X-ray, MRI, CT scan, bone scan[3][2] |
| Differential diagnosis | Osteoarthritis, avascular necrosis of the hip, hernia, trochanteric bursitis[3] |
| Prevention | Improved lighting, removal of loose rugs, exercise, treatment of osteoporosis[1] |
| Treatment | Surgery[1] |
| Medication | Opioids, nerve block[1] |
| Prognosis | ~20% one year risk of death (older people)[3][1] |
| Frequency | ~15% of women at some point[1] |
A hip fracture is a break that occurs in the upper part of the femur (thigh bone), at the femoral neck or (rarely) the femoral head.[2] Symptoms may include pain around the hip, particularly with movement, and shortening of the leg.[2] Usually the person cannot walk.[3]
A hip fracture is usually a femoral neck fracture. Such fractures most often occur as a result of a fall.[3] (Femoral head fractures are a rare kind of hip fracture that may also be the result of a fall but are more commonly caused by more violent incidents such as traffic accidents.) Risk factors include osteoporosis, taking many medications, alcohol use, and metastatic cancer.[2][1] Diagnosis is generally by X-rays.[2] Magnetic resonance imaging, a CT scan, or a bone scan may occasionally be required to make the diagnosis.[3][2]
Pain management may involve opioids or a nerve block.[1][4] If the person's health allows, surgery is generally recommended within two days.[2][1] Options for surgery may include a total hip replacement or stabilizing the fracture with screws.[2] Treatment to prevent blood clots following surgery is recommended.[1]
About 15% of women break their hip at some point in life;[1] women are more often affected than men.[1] Hip fractures become more common with age.[1] The risk of death in the year following a fracture is about 20% in older people.[1][3]
- ^ a b c d e f g h i j k l m n o p q Ferri FF (2017). Ferri's Clinical Advisor 2018 E-Book: 5 Books in 1. Elsevier Health Sciences. p. 615. ISBN 9780323529570. Archived from the original on 13 October 2017.
- ^ a b c d e f g h i j "Hip Fractures". OrthoInfo - AAOS. April 2009. Archived from the original on 29 June 2017. Retrieved 27 September 2017.
- ^ a b c d e f g h Brunner LC, Eshilian-Oates L, Kuo TY (February 2003). "Hip fractures in adults". American Family Physician. 67 (3): 537–542. PMID 12588076.
- ^ Guay J, Parker MJ, Griffiths R, Kopp SL (May 2018). "Peripheral Nerve Blocks for Hip Fractures: A Cochrane Review". Anesthesia and Analgesia. 126 (5): 1695–1704. doi:10.1213/ANE.0000000000002489. PMID 28991122. S2CID 37497179.