Hip and Pelvic Fractures

Hip and pelvic fractures refer to breaks or cracks in the bones of the hip or pelvic area.

The hip is a ball-and-socket joint where the head of the femur (thigh bone) fits into the acetabulum, a part of the pelvic bone. The pelvis, located at the base of the spine, is a structure of bones comprising the ilium, ischium, and pubis.  Fractures in these areas can range from minor cracks to complete breaks, affecting one or multiple parts of the hip and pelvic bones.

Hip and pelvic fractures can be classified into various types, each with unique characteristics and implications for treatment and recovery.

Hip Fractures

• Femoral Neck Fractures: Occurs in the neck of the femur, just below the ball of the hip joint. Common in older adults, particularly those with osteoporosis.
• Intertrochanteric Fractures: Located between the neck and the shaft of the femur, in the trochanteric region. These fractures often require surgical intervention.
• Subtrochanteric Fractures: Found below the trochanter region, extending down the femur. They can be caused by high-energy trauma or stress in weakened bones.

Pelvic Fractures

• Stable Pelvic Fractures: Involves one break in the pelvic ring with minimal displacement. Often caused by low-energy impacts and may be treated non-surgically.
• Unstable Pelvic Fractures: Features multiple breaks in the pelvic ring with significant displacement. Usually results from high-energy trauma and typically requires surgical repair.
• Acetabular Fractures: Involve the socket of the hip joint and can significantly affect the joint’s stability and function.

Stress Fractures

• Insufficiency Fractures: Occur when normal stress is applied to a weakened bone, common in conditions like osteoporosis.
• Fatigue Fractures: Result from repeated stress over time, often seen in athletes or military personnel.

The symptoms of hip and pelvic fractures can vary depending on the type and severity of the fracture, but there are common signs to be aware of.

• Pain
  The most immediate and noticeable symptom, often severe and localised in the hip or groin area. Pain may also radiate to the lower back or down the leg.
• Inability to Bear Weight
  Difficulty or inability to stand or put weight on the affected leg, often accompanied by instability or a feeling of the leg giving way.
• Swelling and Bruising
  Visible swelling and bruising around the hip or pelvic area.
• Abnormal Leg Position
  In severe fractures, the leg on the affected side may appear shorter and turned outward.
• Limited Mobility
  Reduced range of motion in the hip joint, difficulty in moving the leg or hip, or pain during movement.

Preventing hip and pelvic fractures involves addressing risk factors and implementing strategies to strengthen bones and reduce the likelihood of falls. This is especially important for older adults and those with conditions that weaken bone strength.

• Regular Exercise
  Weight-bearing and muscle-strengthening exercises can help maintain bone density and improve balance, reducing the risk of falls.
• Healthy Diet
  A diet rich in calcium and vitamin D supports bone health. Dairy products, leafy green vegetables, and fortified foods are good sources.
• Fall Prevention Measures
  This includes making home safety modifications, such as removing trip hazards, installing grab bars, and ensuring adequate lighting.
• Bone Density Screening
  Regular screening for osteoporosis can help identify individuals at risk and allow for early intervention.
• Lifestyle Modifications
  Limiting alcohol consumption, quitting smoking, and maintaining a healthy weight contribute to overall bone health.
• Medications to Strengthen Bones
  For those with osteoporosis, medications such as bisphosphonates can reduce the risk of fractures.