Hips have a stable ball and socket joint that supports our entire upper body and allows us to walk and move properly. The ball end of the femur, or thigh bone, connects to the socket of the pelvis to form the hip.
Hip fractures are not actually injuries to the hip joint but damage to the upper portion of the femur bone. A fracture in this area will cause pain and issues using your hip even though the fracture is in upper part of your thigh bone.
The bone can fracture in a few different ways including:
Intracapsular Fracture – This fracture affects the part of the neck of the femur that is inside the joint capsule, covered by the cartilage and fluid that holds the hip joint in place.
Intertrochanteric Fracture – This fracture occurs at or below the neck of the femur where it extends from greater trochanter to lesser trochanter. The greater trochanter lies at the upper and outer part of thigh bone and can be felt as a prominent bone near the side pocket area of your pants. The lesser trochanter is a small protrusion on the inner side of thigh bone. Both the greater and lesser trochanter connects many of the important muscles in the pelvis and thigh area.
Subchanteric Fracture – This fracture happens just below the lesser trochanter, at the top of the femur bone.
A severe impact is needed to damage your femur, so it is often the result of a sudden sport or motor vehicle accident. Elderly patients, or patients with medical conditions that make bones more brittle, are more susceptible to fractures and breaks. Osteoporosis, osteogenesis imperfect, or even cancer deposits (metastasis) are a few conditions that can cause bone weakness. When bones are weak, small stress fractures can form even from slight impact.
Hip fractures will cause pain in your groin area. Your pain will increase as you bend and rotate at the hip. Pain can vary in severity, but it will probably keep you from bearing any weight on your affected leg or walking. If the femur has completely broken, your leg will appear shorter and pointing outward.
Dr. Rupesh Tarwala, MD, a best-rated NYC hip surgeon, will be able to easily diagnose a hip fracture after inquiring about your pain, your medical history, and physically examining your hip. An x-ray will capture a clear image of a hip fracture. With an X ray image, Dr. Tarwala will see what type of fracture you have and how severe the breakage is.
Hip fractures are rarely treated with solely conservative methods. A hip fracture, even if it seems to be in proper position to heal, can easily become displaced. To prevent displacement, Dr. Tarwala will take frequent follow up x-rays and suggest you stay on bed rest. He will be sure to explain your condition thoroughly and prepare you for your surgery so you feel comfortable with your treatment. You can be sure that you are in the best hands, as Dr. Tarwala received extensive training in orthopedic hip surgery in multiple countries under the guidance of top leaders in the orthopedic field.
TYPES OF SURGERY
The type of surgery required depends on the severity of the fracture. The goal of all surgeries to correct hip fractures is to hold the femur securely in place to allow the bone to heal in the proper position. In severe cases of hip fracture, Dr. Tarwala may suggest that a partial or total joint replacement would work best in returning your mobility.
Intracapsular Fractures – For fractures that occur in the femoral neck, a single screw, two screws, or single screw and compression plate will be sufficient to keep the bone in place as it heals. Dr. Tarwala may enter the front and/or back of your hip in order to visualize the joint. He will then be able to remove damaged tissue and reconstruct damaged acetabulum.
Hip Joint Replacement – It is possible in both elderly and younger patients that complications can cause long term issues after surgery. If the head of the femur is damaged, it may prevent an adequate amount of blood from reaching the underlying bone and supportive cartilage, despite being screwed into place. If this happens, the cartilage will gradually deteriorate, followed by the bone underneath, causing the joint to destabilize and arthritis to form. If the femoral head has undergone extensive damage, Dr. Tarwala will probably suggest a partial or total joint replacement. In a partial hip joint replacement, only the ball on the femoral head is replaced with a plastic prosthesis. A total hip joint replacement, on the other hand, will replace both the ball and the socket of the hip bone with plastic and metal prostheses.
Intertrochanteric Fractures – These types of fractures are usually simple to manage. Your orthopedic hip surgeon, Dr. Tarwala, will make an incision at the side of your hip. A screw inserted into the femur neck will cross the fracture and be stabilized by a metal plate held alongside the femur bone or nail inside the bone. With steady physical therapy and regular follow ups, this type of fracture should heal in 3-6 months.
Subtrochanteric Fractures – These fractures are typically easier to manage surgically. Dr. Tarwala will use imaging to determine if screws or plates and nails are best to hold the bone in place during healing.
Some hip reparation surgeries are simple enough that you will be able to return home that night. Other open surgeries, namely joint replacements, will require a 1-3 days stay in the hospital. Following the surgery, physical therapy is crucial to regain your ability to walk properly and help the bones in your hip heal.
Your physical therapy regimens will begin with small movements, probably for the first three months. When your hip is stable enough, stretching and strengthening will help you regain normal mobility. Following our physical therapy program regularly is the most effective way to make sure you regain your range of motion, and ensure that your tissues heal without stiffness and scarring.
Your top rated New York Bone and Joint hip surgeon, Dr. Rupesh Tarwala, MD, will follow up with you often, taking X rays to determine how well your fracture is healing. Your physical therapist will also track your progress and make changes to your routine based on your comfort levels. Most, if not all patients, regain their independence and mobility after undergoing a hip fracture correctional surgery.