By Brian Culp, MD
Every year, 300,000 older Americans aged 65 and over are hospitalized for falls that result in hip fractures, according to the Centers for Disease Control and Prevention (CDC).
In many cases, those accidents can mark life-changing events.
That’s why it is so important to prevent falls and fractures before they occur.
Reduce Your Risks
Hip fractures generally occur when you lose your balance, stumble over something or slip, like in the shower or getting out of the tub.
Additionally, vision loss, balance problems, and taking multiple medications can increase the risk for falls and consequently, for breaking a hip.
Though both men and women are at risk for hip fractures as they age, the risk is greater for women. In fact, according to the CDC, women experience three-quarters of all hip fractures. This happens, in large part, because women fall more often than men and more often have osteoporosis, a condition that causes bones to weaken and break more easily.
Taking precautions to help keep bones healthy and prevent a fall that could result in a hip fracture is something everyone should do, particularly older adults.
Steps you can take to reduce your risk for falls and fractures include:
- Eliminate tripping hazards such as throw rugs, loose electrical cords, furniture, and other items in your pathway.
- Make sure hallways and rooms are well lit.
- Install grab bars in the bathroom, specifically near the toilet and in the shower or tub, to provide stability.
- Use a cane or other assistive device if you feel unsteady walking.
- Take your time when rising from a seated or prone position so your body has time to regain its balance.
- With a doctor’s approval, exercising to keep your bones healthy, your muscles strong, and improve balance.
- Review medicines with your doctor to determine if any might make you dizzy or sleepy.
- Get screened for osteoporosis and treated if necessary. Calcium supplements and certain medications can help treat osteoporosis.
Seek Prompt Treatment
If a fall does occur, signs of a hip fracture include:
- Inability to put weight on a leg.
- Severe hip or groin pain.
- Bruising and swelling around the hip area.
- A shift in the position of the leg.
A hip fracture can leave the person bedridden, and for an older person even a few days in bed can impact their overall health. The more time an older patient remains in bed, the harder it is to get them up and moving, which affects their breathing, muscle strength and ability to recover.
Treatment for a hip fracture should be prompt. A fractured hip will not heal on its own and can cause severe pain. Surgery is almost always required for hip fractures. Delaying the procedure typically means that strong pain medication will be necessary, which has its own set of risks as older adults tend to be more susceptible to side effects. Further, pain medications can exacerbate confusion or dementia.
Surgery usually involves a minimally invasive or X-ray guided procedure in which the hip is either repaired or partially or totally replaced. Patients typically stay in the hospital for four days, and physical therapy is part of the recovery process.
If you or a loved one experience signs of a hip fracture, call 9-1-1 and seek emergency care.
Hip Fracture Program Can Improve Recovery
Penn Medicine Princeton Medical Center’s (PMC) Hip Fracture Program is designed to treat patients faster, improving their chances of making a full recovery.
The Hip Fracture Program is based on a treatment model of collaborative, standardized care and protocols that promote expeditious surgery, timely medical support, rapid mobilization, earlier discharge, and increased attention to bone health.
The program features standardized order sets beginning in the Emergency Department (ED). A person in the ED with a confirmed hip fracture is admitted by the ED physician and receives a consult with an orthopedic surgeon. If indicated, a cardiologist will also consult with the patient to clear them for surgery. The goal is to have a patient medically stabilized and in surgery within 24 hours of arrival at the ED.
Following surgery, most patients will be admitted to the Surgical Care Unit or Acute Care for the Elderly (ACE). When indicated, patients are admitted to telemetry, a unit where patients are under constant electronic monitoring.
Discharge planning begins immediately, with the goal to discharge the patient to home, acute rehabilitation, or a skilled nursing facility within three to four days post-surgery.
The program also adheres to a multimodal approach to pain management, meaning that rather than relying on opioid pain medicines to control pain, pain is typically managed through a variety of non-habit forming drugs such as a prescription-strength Tylenol or Motrin. This approach minimizes medication side effects.
For more information about or find an orthopaedic surgeon affiliated with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.
Brian Culp, MD, is an orthopaedic surgeon on the Medical Staff of Penn Medicine Princeton Health.