Why do Hip Fractures Occur?
The incidence of fragility fractures is on the rise
Hip fractures in particular is a growing a concern.
It is particularly common among the elderly population
Characteristic and Important Feature:
- It typically occurs after a trivial injury resulting from a low energy fall.
- may also be associated with fractures in the wrist for example while attempting to break the fall with the hand.
- underlying concern of osteoporosis and brittle bones makes them more susceptible to fractures.
- compounding medical issues of concern
- poor coordination and balance that may contribute to the fall for example
- Patients with Hip Fractures may require early surgical intervention
- Surgical stabalization will help restore mobility and prevent other associated complications
- A holistic assessment should be performed.
- Awareness on Fall prevention and Screening for Osteoporosis is crucial to prevent secondary fractures
What are the Concerns after a Hip Fracture?
The major concern is the complications associated with hip fractures due to immobility.
The elderly who is bed bound after a hip fracture would easily succumb to the following:
- chest infection
- urinary tract infection
- bed sores
- deep vein thrombosis,
- muscle wasting and delirium.
Therefore, surgery is advisable soonest possible if there are no major contraindications.
The benefit of early surgery is early mobilization.
This will prevent the associated complications of concern.
Furthermore, early surgery and early mobilization will lead to a satisfactory functional restoration.
What are the Management Options after a Hip Fracture?
Hip Fractures in the elderly will benefit from surgical intervention.
However, it may be treated conservatively if the risk of surgery outweighs the benefits.
The Surgical options typically depends on the site and type of the hip fracture.
- Hip Fractures involving the neck of the femur which are unstable would require a Replacement Surgery
2. Hip Fractures involving the trochanteric region of the femur region would require an Internal Fixation.
- Surgical intervention be it a Replacement Surgery of Fixation Surgery is to restore joint function and stability.
- It allows early range of motion of the hip joint and early weight bearing on the affected limb.
The goal of surgery is restore function to the pre-fracture state. However, early surgery with a regulated and consistent post-operative physiotherapy is of paramount importance.
OrthoGeriatrics – Orthopaedic Care for the Elderly
Rising number of elderly population has lead to an increasing incidence of orthopaedic concerns.
There are 2 main arms of concerns:
- Joint degeneration which occurs with age. It can involve any joint but the knees in particular may be of significant concern due to knee osteoarthritis.
– issues are mostly non – urgent and are chronic in nature
2. Osteoporosis and the rising incidence of fragility fractures. The rising incidence of hip fractures in the elderly is an example.
– usually occur after a trivial injury that are acute and will require immediate medical attention
Management Principles remain the same however there is a paradigm shift in the approach particularly for acute management of a fracture.
– Concept of co-management allows all relevant specialist (for example a Geriatrician) and allied health to deliver care in synergy.
– Multidisciplinary Approach is an important aspect in managing other associated medical conditions
– Specialized attention can be given concurrently.
– Allows early optimization for Surgery (if indicated) and effective rehabilitation.
– Lower complications rate.
– Integrated Model of Care has been scientifically proven to provide superior outcomes
-The goal of the multidisciplinary approach is to restore function and mobility.