Hip FracturesComprehensive Care
Comprehensive care for hip fractures from emergency treatment to full recovery. Learn about treatment options and rehabilitation strategies.
Hip fractures are serious injuries that typically occur in older adults, often as a result of falls. They involve breaks in the upper portion of the femur (thigh bone) near the hip joint. These fractures require immediate medical attention and usually surgical treatment to restore function and mobility.
Common Symptoms
- • Severe hip or groin pain
- • Inability to bear weight on affected leg
- • Shortened, externally rotated leg
- • Swelling and bruising around hip
- • Inability to move hip or leg
- • Deformity of the hip area
Emergency Signs
- • Call 911 immediately
- • Do not attempt to move the person
- • Keep the person warm and comfortable
- • Monitor for signs of shock
- • Do not give food or water
Types of Hip Fractures
Fractures at the narrow part of the femur near the hip joint
Location
Between femoral head and greater trochanter
Risk Factors
High risk of avascular necrosis
Treatment
Often requires hip replacement
Healing: Poor blood supply, slow healing
Fractures between the greater and lesser trochanters
Location
Below the femoral neck
Risk Factors
Better blood supply than neck fractures
Treatment
Internal fixation with screws/plates
Healing: Good healing potential
Fractures below the lesser trochanter
Location
Upper shaft of femur
Risk Factors
High stress area, challenging to treat
Treatment
Intramedullary nailing
Healing: Variable, depends on fracture pattern
Incomplete fractures from repetitive stress
Location
Usually femoral neck or shaft
Risk Factors
May progress to complete fracture
Treatment
Conservative vs. surgical
Healing: Good with early recognition
Treatment Timeline
Goals: Stabilize patient and prepare for surgery
Key Interventions
- • Pain management and immobilization
- • Medical optimization for surgery
- • Blood work and imaging studies
- • Anesthesia consultation
- • DVT prophylaxis initiation
- • Surgical planning and consent
Goals: Restore hip anatomy and function
Key Interventions
- • Hip replacement (hemiarthroplasty or total)
- • Internal fixation with screws/plates
- • Intramedullary nailing
- • Bone grafting if needed
- • Post-operative monitoring
- • Early mobilization planning
Goals: Restore function and prevent complications
Key Interventions
- • Progressive weight bearing
- • Physical therapy program
- • Occupational therapy
- • Fall prevention education
- • Bone health optimization
- • Long-term follow-up care
Rehabilitation Program
Frequency: Daily with supervision
Bed Mobility
Rolling, scooting, sitting up in bed
Goals: Prevent complications, maintain circulation
Transfer Training
Bed to chair, chair to toilet transfers
Goals: Functional independence
Ankle Pumps
Flex and point feet to prevent blood clots
Goals: DVT prevention
Frequency: 2-3 times daily
Glute Sets
Tighten buttock muscles while lying down
Goals: Hip stability and strength
Quad Sets
Tighten thigh muscles, push knee down
Goals: Quadriceps strength
Hip Abduction
Slide leg out to side while lying down
Goals: Hip abductor strength
Frequency: 3-4 times per week
Gait Training
Walking with assistive devices
Goals: Normal walking pattern
Balance Training
Standing balance and weight shifting
Goals: Fall prevention
Functional Activities
Stairs, getting in/out of car
Goals: Return to daily activities
Risk Factors
- • Age over 65
- • Postmenopausal women
- • Bone density loss
- • Muscle weakness
- • Osteoporosis
- • Previous fractures
- • Vitamin D deficiency
- • Chronic diseases
- • Sedentary lifestyle
- • Poor nutrition
- • Smoking
- • Excessive alcohol
- • Fall hazards at home
- • Poor lighting
- • Loose rugs
- • Icy conditions
Bone Health
- • Adequate calcium and vitamin D intake
- • Regular weight-bearing exercise
- • Bone density screening
- • Osteoporosis treatment if needed
- • Avoid smoking and excessive alcohol
Fall Prevention
- • Remove home hazards (rugs, clutter)
- • Improve lighting throughout home
- • Install grab bars and handrails
- • Regular vision and hearing checks
- • Balance and strength training
Call 911 Immediately
- • Severe hip pain after fall
- • Inability to bear weight
- • Visible deformity of hip/leg
- • Shortened, rotated leg position
Do Not
- • Attempt to move the person
- • Give food or water
- • Apply ice directly to skin
- • Try to straighten the leg
Mobility Aids
- • Walkers and rollators
- • Crutches and canes
- • Wheelchairs
- • Transfer boards
Home Safety
- • Grab bars and handrails
- • Shower chairs
- • Raised toilet seats
- • Non-slip mats
Recovery Support
- • Hip abduction pillows
- • Compression stockings
- • Reachers and grabbers
- • Dressing aids
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