Hip Fractures

Author: Judy Thomas, M.D. & Kathleen Pace Murphy, PhD., M.S.

Key Points

In 2010, there were approximately 258,000 persons admitted to hospitals with a diagnosis of fractured hips (National Hospital Discharge Survey, 2010).

The most common etiology for fractured hips is falls.

One out five older adults diagnosed with hip fractures will die within the first year of their injury (Farahmand, Michaelsson, Ahlbom et al. 2005).

 

Overview

Incidence of hip fractures is bimodal distribution with one peak represented by hip fractures due to high energy trauma in young adults and the larger peak seen in elderly population due to low-energy injury.

The term “hip fractures” encompasses five subtypes of fractures of the proximal femur. The subtypes are: There are two categories of fractures:

 

Intervention

Surgical repair for a hip fracture is usually very effective. 

Without surgery, many patients are left with significant pain, a shortened leg and immobility which can lead to complications such as pneumonia, DVT and pressure ulcers. 

A conservative approach may be an option in severely demented, very ill, or terminal patients if they are comfortable. In certain cases, internal fixation with pinning can be considered palliative. 

Complications following hip fractures include deep vein thrombosis and pulmonary embolism, urinary tract infections, pressure ulcers, pneumonia, and delirium. 

Delirium is the most common complication following hip fracture. 

Common causes of delirium in post-operative hip fracture patients include:

 

References

Anatapur, P. (2011). Fractures in elderly: When is hip replacement a necessity? Clinical Interventions in Aging:6: 1-7.

Ellis, A.A. & Trent, R.B. (2001). Hospitalized fall injuries and race in California. Injury Prevention;7:316–20.

Farahmand, B.Y., Michaelsson, K., Ahlbom, A., Ljunghall, S., Baron, J.A. (2005). Swedish Hip Fracture Study Group. Survival after Hip Fracture. Osteoporosis International;16(12):1583-90.

Kristensen, M.T. (2011). Factors affecting functional prognosis of patients with hip fractures. European Journal of Physical Medicine and Rehabilitation;47: 257-264.

National Hospital Discharge Survey (NHDS), National Center for Health Statistics. Available at: http://205.207.175.93/hdi/ReportFolders/ReportFolders.aspx?IF_ActivePath=P,18 Accessed August 29, 2013.