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Fracture of the Hip / Fracture of the Head of the Femur
Definition: A brake in the continuity of the proximal end of the femoral bone.
Causes: A common cause of hip fractures result from minor trauma such as a fall onto a hip weakened by osteoporosis. The main cause of hip fractures is the result of car accidents where a normal bone subjected to abnormal forces. In the U.K, the mortality rate following a hip fracture is quite hip. The majority of hip fractures occur in elderly women.
Strictly speaking, a true hip fracture involves the hip joint however, there are numerous sub-types of fractures involving the femoral head and neck, that are colloquially referred to as hip fractures. The sub-types of hip fractures include:
• Femoral head fracture. Usually the result of high impact trauma with associated dislocation of the joint.
• Femoral neck fracture also referred to as subcapital, or intracapsular fractures. These denote a fracture adjacent to the femoral head, which may negatively affect the blood supply to the head of the femur and ultimately lead to its avascular necrosis.
• Intertrochanteric fracture. Describes a fracture line running between the two trochanters of the femur. It is the most common type of 'hip fracture'.
• Subtrochanteric. Is a fracture located directly distal to the lesser trochanter, and may extend down the shaft of the femur.
Examination: The typical presentation of a hip fracture is that of an elderly patient (usually female) who sustained a low impact fall and incurred subsequent pain and inability to weight-bear.
Observation: A patient suffering from a fractured hip will usually be unable to weight-bare and the affected limb is likely to be shortened and externally rotated. Vibration over the greater trochanter with a 128Hz tuning fork may cause an aggravation in symptoms.
Definitive diagnosis and fracture classification is achieved via radio-imagery. A suspected fracture is a medical emergency.