Hip Fracture

A hip fracture is a serious condition and often painful, usually presenting with pain and an inability to move the affected leg or knee. In some cases, the bone may be so weak that a fracture occurs spontaneously during activities like walking or standing.

  • Have you sustained a hip injury recently? Consult our MOH-accredited hip fracture specialist immediately for a personalised treatment plan.
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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

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What are Hip Fractures?

A hip fracture is a break in the upper portion of the femur (thighbone). It can affect one of four areas: the femoral neck, intertrochanteric area, subtrochanteric area, or femoral head.

Causes of Hip Fractures

Hip fractures are primarily caused by the following factors:

  • Falls due to Weakened Bones
    The most common cause of hip fractures, especially in the elderly, is falling. This can be attributed to factors such as weakened bones due to osteoporosis, balance issues, or impaired vision. Even a minor fall or a simple twisting motion can lead to a fracture in individuals with weakened bone structures.
  • Direct Impact on the Hip
    Younger individuals may experience hip fractures as a result of high-energy impacts. These include scenarios such as motor vehicle accidents or falls from a height. In these cases, the force of the impact rather than bone weakness is the primary cause.
  • Repetitive Stress on the Hip
    Another contributing factor can be stress fractures, which occur due to repeated impact activities. These are common in athletes, particularly long-distance runners or those engaging in intense physical activity without adequate conditioning.

Symptoms and Signs

The presentation of a hip fracture typically involves a combination of pain and physical limitations:


  • Pain: Individuals with a hip fracture often experience severe pain in the groin and upper thigh region. This pain is usually acute and worsens with any attempt to move or put weight on the affected leg.
  • Inability to Bear Weight: An indicator of a hip fracture is the inability to stand, bear weight, or move the upper part of the leg or knee. In some cases, especially with undisplaced fractures, it might be possible to bear some weight on the leg, but this often results in severe pain and should be avoided.
  • Physical Deformities: A hip fracture may cause the leg on the injured side to appear shorter and may result in the outward turning of the leg.

Diagnosis

Diagnosis can help determine the severity of the hip fracture.

  • Clinical Assessment
    Initially, the hip specialist conducts a thorough examination. This includes checking the sensation, movement, and circulation in the lower leg and assessing for other injuries, particularly if there’s a suspicion of a hip dislocation.
  • Imaging Studies
    X-rays are the primary tool for diagnosing hip fractures, helping locate the fracture and determining its severity. In some instances where X-rays may not reveal smaller fractures, more sensitive imaging techniques like MRI or CT scans can be employed.

Treatment Options

Most hip fractures require surgical intervention to reduce the risk of hip complications and to preserve as much of the hip’s function as possible. The choice of surgical procedure depends on the type and location of the fracture, as well as the patient’s age and overall health condition.

  • Surgical Fixation - This method involves the use of metal devices, such as nails, screws and plates, to hold the broken bone fragments in proper alignment. It is commonly used for fractures that are not displaced or are in a position where they can be realigned and stabilised.
  • Partial Hip Replacement - This procedure, also known as hemiarthroplasty, is typically considered for older patients with certain types of fractures, where the bone quality is poor or the fracture is unlikely to heal well with fixation alone. It involves replacing the femoral head with a prosthetic implant.
  • Total Hip Replacement - In cases where the hip joint is severely damaged or there are pre-existing joint problems, a total hip replacement may be suggested. This involves replacing both the femoral head and the socket of the pelvis with prosthetic components.

Prevention Strategies

Preventing hip fractures involves addressing the various risk factors associated with the condition:

  • Adequate Calcium and Vitamin D Intake to Avoid Osteoporosis
    Ensure adequate calcium and vitamin D intake to maintain bone density, particularly for older individuals. This helps in reducing the risk of osteoporosis, a major contributor to hip fractures.
  • Implement Strategies to Prevent Falls
    As falls are a common cause of hip fractures, especially in the elderly, strategies should be implemented to prevent falls. This includes maintaining good physical health to improve balance and strength, regular eye examinations, and making living spaces safer by removing trip hazards.
  • Strengthen the Hip Muscles and Bones
    Engaging in regular weight-bearing exercises like walking helps in maintaining bone density and muscle strength, reducing the risk of falls and fractures.
  • Healthier Lifestyle Choices for Bone Health
    Smoking and excessive alcohol use should be avoided as both can lead to decreased bone density.

Schedule An Appointment With Us

Have You Sustained A Hip Injury Recently?

Consult our MOH-accredited hip fracture specialist for a personalised treatment plan.

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Dr Poh Seng Yew

MBBS

MRCSEd

MMED (Ortho)

FRCSEd

With over 20 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.

  • Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
  • Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
  • Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
  • Master of Medicine (Orthopaedic Surgery), National University of Singapore
  • Member, Royal College of Surgeons of Edinburgh (MRCSEd)
  • Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore

 

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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
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    Mount Elizabeth Novena Specialist Centre
    38 Irrawaddy Road, #08-62/63
    Singapore 329563

    Frequently Asked Questions (FAQ)

    How Long Is the Recovery Time After a Hip Fracture?

    Recovery from a hip fracture typically takes a few months, influenced by factors such as age, general health, the fracture’s type and severity, surgical success, and rehabilitation progress. During recovery, physical therapy and lifestyle adjustments play a role in healing and regaining mobility​​.

    What Are the Complications of Hip Fractures?

    Complications from hip fractures can include mobility issues, leading to blood clots, infection, pneumonia, muscle atrophy, bedsores, nerve damage, and arthritis. Timely and effective treatment can help minimise these risks​​.

    Can You Still Walk with a Fractured Hip?

    Walking with a fractured hip is typically extremely painful and can worsen the injury. Should you experience these symptoms, contact our hip specialist immediately to assess the extent of the fracture and to initiate appropriate treatment.

    Can the Elderly Recover from a Hip Fracture?

    Elderly patients can recover from a hip fracture, especially with prompt, appropriate treatment and a dedicated rehabilitation plan. Recovery may take longer and requires close monitoring and support from our hip specialist.

    What Should You Do After Hip Fracture Surgery?

    After hip fracture surgery, follow your hip specialist’s postoperative care plan, which likely includes rest, physical therapy, and possibly using assistive devices such as crutches or a walker. Regular check-ups with your hip specialist can help monitor healing and adjust the treatment plan as needed.