injuries and poisoning
Hip Fractures
Introduction
Hip fractures may occur in the round upper end (head) of the thighbone, in the narrow part of the thighbone just below the head (neck), or in the bumps in the broader area just below the neck. Hip fractures usually occur in older people and often result from a minor fall, particularly in people with osteoporosis. Usually, moving the affected leg, standing, and/or walking causes substantial pain Doctors confirm the diagnosis with x-rays or sometimes other imaging tests. Surgery is usually done to repair the hip or sometimes to replace the joint. (See also Overview of Fractures .) Hip fractures are more common among older people because they are more likely To have Osteoporosis (which weakens bones) To Falls in Older Adults None To take medications that increase the risk of hip fractures (see Aging and Medications ) Most hip fractures result from falls, but in older people with osteoporosis, the stresses of ordinary activity—such as rolling over in bed, getting up from a chair, or walking—can break the hip. The hip joint consists of the round upper end (head) of the thighbone (femur) and part of the pelvic bone. The round head of the thighbone fits into the cup-shaped cavity in the pelvic bone, making a ball-and-socket joint. Below the head, the thighbone narrows, forming the neck of the thighbone. Below the neck is a broader area that contains two large bumps (called trochanters). The strong muscles of the legs and buttocks are attached to the trochanters by tendons. Most hip fractures occur just below the head of the thighbone. There are two common types: Femoral neck (subcapital) hip fractures, which occur in the neck of the thighbone Intertrochanteric hip fractures, which go through the large bumps just below the neck Hip fractures can also occur in the head of the femur or below the large bumps (called subtrochanteric fractures). are particularly problematic because the fracture often disrupts the blood supply to the head of the bone. Without a good blood supply, the bone cannot grow back together, and it may eventually collapse and die (called Osteonecrosis ). Severe, painful arthritis may develop. Intertrochanteric hip fracturesrarely interrupt the blood supply to the head of the femur. The broken surface of the bone may bleed but not usually enough to cause serious problems. These fractures usually result from a fall or direct blow. 