Hip fractures are a common injury among older adults, often caused by falls or weakened bones due to osteoporosis. They can significantly affect mobility and overall health, making timely treatment essential. The right approach depends on factors such as the patient’s overall health, mobility level, and the nature of the fracture. This guide outlines the available treatment options for hip fractures in older adults, including surgical and non-surgical approaches, as well as strategies for prevention.
Surgical Treatment Options
Surgery is the most common approach for treating hip fractures, as it helps stabilise the bone and allows for earlier movement. The type of surgery depends on the location and severity of the fracture, as well as the patient’s overall health.
Hip Pinning (Internal Fixation)
Metal screws or a plate are used to secure the fractured bone, keeping it in position while it heals. This method is typically suitable for fractures that remain well-aligned and have not significantly shifted. It helps maintain bone stability and allows for gradual healing over time.
Hip Replacement (Partial or Total)
If the fracture has caused extensive joint damage or disrupted blood supply to the bone, replacing part or all of the hip joint may be recommended.
- Partial Hip Replacement (Hemiarthroplasty): The damaged portion of the femur is replaced with an artificial implant while keeping the natural hip socket intact.
- Total Hip Replacement: Both the femoral head and the hip socket are replaced with prosthetic components. This approach may be more suitable for individuals with arthritis or significant joint damage.
Both procedures help improve mobility and relieve discomfort, particularly in those with weakened bones or joint degeneration.
Intramedullary Nailing
A metal rod is inserted into the centre of the femur to realign and stabilise the fractured bone. This technique provides strong internal support, helping to maintain proper alignment during healing. It is often used for fractures that occur lower down the femur and allows for earlier weight-bearing in many cases.
Non-Surgical Treatment Options
Non-surgical treatment is considered for patients who are unable to undergo surgery due to medical conditions or for fractures that are stable and unlikely to shift. This approach focuses on managing pain and preventing complications.
Bed Rest and Pain Management
Pain relief medications help manage discomfort while minimising side effects. Prolonged bed rest is discouraged to lower the risk of blood clots, infections, and muscle weakness. Positioning techniques and support cushions may be used to relieve pressure on the injured area and improve comfort.
Limited Weight-Bearing with Assistive Devices
For stable fractures, patients may be encouraged to use crutches, a walker, or a wheelchair to aid movement while reducing strain on the healing bone. Weight-bearing is often restricted based on medical advice to prevent the fracture from shifting. Regular monitoring helps assess when gradual weight-bearing can be introduced.
Physiotherapy and Mobility Exercises
Gentle movement and targeted exercises help maintain muscle strength and joint flexibility. Physiotherapists may introduce guided mobility exercises to improve circulation and prevent stiffness. While non-surgical treatment supports fracture healing, it may result in reduced long-term mobility compared to surgical intervention, especially in patients with pre-existing movement limitations.
Preventing Hip Fractures in Older Adults
Taking steps to prevent hip fractures can help maintain long-term mobility and reduce the risk of serious injuries.
Bone Health Maintenance
A diet rich in calcium and vitamin D, along with weight-bearing exercises, helps support bone strength. Medication may be recommended for individuals with osteoporosis.
Fall Prevention Strategies
Reducing fall hazards in the home, wearing supportive footwear, and maintaining good vision can help lower the risk of falls. Strength and balance exercises also improve stability.
Medical Management of Chronic Conditions
Conditions such as arthritis, Parkinson’s disease, and heart disease can affect movement and balance. Managing these conditions with appropriate treatment and lifestyle changes can help reduce fall risk.
Conclusion
Hip fractures in older adults can affect mobility and overall health, but appropriate treatment helps restore movement and reduce complications. Surgery is often recommended to stabilise the fracture, while non-surgical approaches may be suitable in certain cases. Preventive measures, such as maintaining bone strength and reducing fall risks, can help lower the likelihood of future fractures.
For guidance on treatment and prevention, book a consultation today to explore the best options for your needs.
