HIP FRACTURES IN THE ELDERLY

Posted by e-Medical PPT
A hip fracture is a femoral fracture that occurs in the proximal end of the femur,near the hip joint.
Hip fracture following a fall is likely to be a pathological fracture. The most common cause of weakness in bone are:
    * Osteoporosis
    * Homocysteine
    * Other metabolic bone diseases such as Paget's disease, osteomalacia, osteopetrosis and osteogenesis imperfecta. Stress fractures may occur in the hip region with metabolic bone disease.
    * Benign or malignant primary bone tumours are rare causes of hip fractures
    * Metastatic cancer deposits in the proximal femur may weaken the bone and cause a pathological hip fracture
* Femoral head fracture denotes a fracture involving the femoral head. This is usually the result of high energy trauma and a dislocation of the hip joint often accompanies this fracture
* Femoral neck fracture (subcapital, or intracapsular fracture)
* Subtrochanteric fracture actually involves the shaft of the femur immediately below the lesser trochanter and may extend down the shaft of the femur.
The classic clinical presentation of a hip fracture is an elderly patient who sustained a low-energy fall and now has pain and is unable to bear weight. On examination, the affected extremity is often shortened and unnaturally, externally rotated compared to the unaffected leg.
X-rays of the affected hip usually make the diagnosis obvious; AP and lateral views should be obtained.
Most hip fractures are treated by orthopedic surgery, which involves implanting an orthosis.For low-grade fractures (Garden types 1 and 2), standard treatment is fixation of the fracture in situ with screws or a sliding screw/plate device.In elderly patients with displaced fractures many surgeons prefer to undertake a Hemiarthroplasty.An intertrochanteric fracture, below the neck of the femur, has a good chance of healing. Treatment involves stabilizing the fracture with a lag screw and plate device to hold the two fragments in position.An intertrochanteric fracture, below the neck of the femur, has a good chance of healing. Treatment involves stabilizing the fracture with a lag screw and plate device to hold the two fragments in position.


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