Each year more than 300,000 people in the U.S. experience a hip fracture, and most of these fractures occur in people 65 and older who are injured during a fall. While risk of hip fracture rises with age, eating healthy, exercising, and taking steps to improve and maintain muscle and bone health, even at a young age, can help prevent future hip fractures.
Dr. Christopher Jarrett, MD, an orthopaedic surgeon at Wilmington Health, specializes in hips, knees and general orthopaedic conditions. Jarrett said he’s treated many patients with hip fractures.
“As the general population ages, I think it’s something that we are going to see more and more of,” he said.
1. Falls are the most common cause of hip fractures
Hip fractures can be very painful, and Jarrett said their most common cause is a fall. Additionally, he said a major risk factor for hip fractures is having osteoporosis.
According to the U.S. National Library of Medicine, in elderly people who have bones weakened by osteoporosis even little trauma, like walking, may result in a hip fracture. With weakened bones, hip fractures can also follow a slip or twisting injury.
Jarrett said having a bone density less than two standard deviations below the norm also increases one’s risk for hip fracture.
“Balance issues or a neurological issue that would predispose a patient to being a fall risk would also be a big risk factor for hip fracture,” Jarrett said.
According to American Academy of Orthopaedic Surgeons when younger people have hip fractures it’s often due to a high-energy event, such as fall from a ladder or automobile accident.
2. Not all hip fractures are the same; treatment options differ
Treatment depends on the type of hip fracture, and type depends on where the hip bone is broken.
“It’s amazing that all of these breaks can happen within just a few inches of each other, but they all respond very differently and are treated very differently because of the anatomy of the bone and the blood supply to the bone,” said Jarrett.
“One of the types that we see is the Pubic Rami Fracture,” he continued. “It’s treated non-operatively. It hurts a lot, but you’re on a walker for four to six weeks and then it heals and you get better, but if you have a femoral neck fracture, intertrochanteric, subtrochanteric fracture, those always require surgery.”
Some patients may need a partial or total hip replacement, and recovery times also vary.
“You can expect to be down for about six weeks if it’s a pubic rami fracture which doesn’t need surgery,” Jarrett said. “If you have an intertrochanteric fracture or a femoral neck fracture which do require surgery, you can be down for three to six months. “
3. In the elderly, a hip fracture can sometimes shorten a person’s life
“Historically we’ve seen the one-year mortality rate for hip fractures hovering around 30 percent,” said Jarrett. “That means about one third of patients over 65 who break their hip could potentially die within a year. It’s not always the hip fracture that’s the cause of it, but it’s a symptom of the decline.”
Jarrett said recovering from the hip fracture takes a toll on the body. For many, the process includes going through surgery and undergoing physical therapy and rehabilitation.
“If you don’t have that sort of reserve (inside) to dig into and call upon to recover from that it can take a toll on you and lead to an unfortunate event,” Jarrett said.
Jarrett also said the longer a patient waits to get their fractured hip fixed the more likely they are to have a negative outcome.
“If a hip is broken and we can get the hip fixed within 48 hours the patient does a lot better,” he said.
Prompt treatment helps patients avoid complications, such as blood clots and pneumonia, that can come from staying in bed for long periods of times.
4. Hip Fractures can significantly impact one’s life
“A lot of patients will lose their independence or autonomy and have to go to an inpatient rehab facility or skilled nursing facility for some weeks while they convalesce, and that can take a toll on patients mentally, emotionally and physically,” said Jarrett. “If they are living a life that they are happy with and suddenly they are facing these social changes, that can have dramatic effect.”
Jarrett said the recovery process can be difficult for many patients. He encourages patients’ family members and those providing care to be supportive.
“If your hip is broken, you’re very dependent on others for everything you need,” Jarrett said. “I sometimes see in patients that loss of independence can be emotionally very hard for them, especially in older patients. Sometimes the best medicine is just an encouraging word or a reminder that they will get through it and that they’ll be back on their feet and back to their life and not to give up.”
5. Fall prevention and an active, healthy lifestyle can help prevent hip fractures
“One thing you can do to help prevent a hip fracture is lead an active and healthy lifestyle,” said Jarrett. “There’s been evidence that doing weight-bearing exercises, such as walking or even lifting weights are good for improving bone density. It also improves your balance and coordination and makes falling less likely. If you have a diagnosis of osteoporosis talk to your physician about whether you are a candidate for one of the medicines that help build bone density.”
Jarrett said starting to take care of your bones early in life is important.
“One of the most important things that you can do is maximize your bone density while you still can,” he said. “That means starting at an early age even in your teens and early twenties by living an active and fit lifestyle and maximizing your bone density because decline in bone density starts as early as your mid to late twenties.”