A hip fracture is a serious injury, involving a break in the upper portion of the femur (thigh bone) near the hip joint. These are generally categorized into two types: acute fractures, caused by a sudden impact or fall, and stress fractures, which are hairline cracks caused by repetitive strain or weakened bones.
The symptoms differ significantly between a sudden break and an overuse injury.
Acute Hip Fracture:
Inability to Move: Immediate inability to walk or stand after a fall.
Severe Pain: Intense pain in the outer upper thigh or groin.
Deformity: The leg on the injured side may appear shorter or turned outward.
Bruising: Rapid swelling and discoloration around the hip area.
Hip Stress Fracture:
Activity-Related Pain: A dull ache in the groin or front of the hip that starts during exercise and goes away with rest.
Progressive Discomfort: Over time, the pain may occur during simple tasks like walking or even while resting at night.
Tenderness: Soreness when pressure is applied to the front of the hip.
Physical Exam
X-rays: The first line of defense to identify obvious fractures or bone displacement.
MRI: Often used when a stress fracture is suspected, as these hairline cracks are frequently invisible on standard X-rays for several weeks.
Treatment is based on the location of the fracture and whether the bone has shifted out of place.
Non-Surgical Management: Reserved for very specific, stable stress fractures; involves limited weight-bearing with crutches and modified activity.
Internal Fixation: Using screws, nails, or plates to hold the bone together while it heals.
Hemiarthroplasty: Replacing the "ball" of the hip joint (femoral head) while leaving the natural socket intact.
Total Hip Replacement: Replacing both the ball and the socket, often recommended if the patient had pre-existing arthritis.
Physical Therapy: An essential post-surgical step to regain mobility, balance, and muscle strength.
Bone Health Optimization: Prescribing calcium, Vitamin D, or osteoporosis medications to prevent future fractures.