Diagnosis

HIP FRACTURE


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 Definition A hip fracture refers to a break of the top part of the femur bone where it connects to the pelvis.
Details Hip fractures are classified into many types. The most common are known as femoral neck fractures, intertrochanteric fractures and subtrochanteric fractures.
Causes Falls are the most common cause of hip fractures. The majority of these fractures occur in the elderly. High energy trauma (such as in motor vehicle accidents), however, may cause hip fractures in younger patients.
Diagnosis Most hip fractures are diagnosed by a history of a fall or an accident followed by severe hip pain. The leg may appear abnormally rotated and any attempt to move the hip will result in a significant increase in pain level.

Plain x-rays are used to confirm the diagnosis. Occasionally, a bone scan or MRI is needed to prove that a fracture is present.

Hip Fracture Patient with Externally Rotated Leg
Treatment Non operative: Non operative treatment is only rarely indicated for hip fractures. It is usually reserved for those patients that are not able to tolerate the risks associated with anesthesia.

Operative:
The type of hip fracture (femoral neck, intertrochanteric, subtrochanteric) directs the type of surgery. For femoral neck fractures, multiple screws or a partial replacement are the two most common treatments. For intertrochanteric fractures, a hip screw and side plate is most often employed. Finally, for subtrochanteric fractures, either an intermedullary rod or the hip screw with side plate construction is used.

Hip fracture treatment is highly individualized. The choices in treatment must be discussed with the surgeon in conjunction with the patient's fracture type and medical condition.

Open reduction, internal fixation of a subtrochanteric hip fracture
Prevention

Maintaining balance skills and muscle coordination may help prevent some falls and thus some hip fractures.


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