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 Cosmetic Surgery & Aesthetic Procedures

April 2012
A Hip Option
Dr Somasekhar Reddy
Hip fractures are commonly referred to the fractures of the proximal part of the thigh bone, which forms one side of the hip joint. Patients with hip fractures may come in a variety of ways, ranging from a 30-year-old man in a serious state after a high-speed motor vehicle accident to an 80-year-old woman reporting hip pain after a trivial fall

Osteoporosis in the elderly contributes to most of these fractures. Majority of the hip fractures in elderly occur either along the neck of the femur or along the trochanteric region of the femur, which are mechanically weak. With appropriate care and attention to lifestyle some of these fractures can be prevented.

Symptoms And Signs
  • Severe pain in hip or groin area t Inability to move the leg after a trivial fall, twisting injury, slip or a fall
  • Inability to stand or put weight on that leg
  • Stiffness, bruising and swelling in and around the hip area
  • Shorter leg on the side of injury
  • The leg and foot may turn outward
Treatment Options
Surgery is almost always the best option for treating hip fractures. Typically, nonsurgical alternatives, such as traction, are advised only if you have a serious illness that makes surgery too risky.

Femoral Neck Fractures
  • Hemiarthroplasty or replacement of certain parts of the femur: Removing the head and neck of the femur and replacing them with a metal prosthesis.
  • Total hip replacement: Theprocedure involves the replacement of upper femur and the socket in the pelvic bone with prostheses. Total hip replacement may be a good option if joint damage from arthritis or a prior injury had preceded the fracture.
  • In relatively young patients, doctors try to avoid replacing the upper part of the thigh bone by fixing the fracture with screws.
Trochanteric Fractures
  • The fracture is fixed with a metal screw with side plate assembly (hip compression screw) or sometimes using a metal rod-nail into the bone with screws into the neck and head of femur.
  • A physiotherapist can help you walk again after surgery. If you are fit, physiotherapy can be started the very next day after the operation.
Complications are largely due to relative immobility of the patient
  • Blood clots in the veins
  • Fat embolism: Fat globules from the fracture site enter the blood stream and reach the lungs.
  • Electrolyte imbalance
  • Bed sores
  • Chest infection
Weight-bearing exercise, such as walking, can help keep bones strong and prevent hip fractures. Most patients do very well after a successful surgery. It is important to get the correct treatment without delay. Prior health problems, debility, complications following surgery and forced prolonged bed rest postsurgery – all have an adverse impact on the outcome of the surgery.

Risk Factors
  • Your gender (Women are twice as likely to fracture their hips as men after menopause.)
  • A family history of being thin or tall and previous cases of fractures in
    family members.
  • Poor eating habits. Not getting enough calcium and Vitamin D.
  • Sedentary life or inactivity
  • Smoking
  • Medical conditions that cause dizziness and those that affect an individual’s sense of physical balance. (e.g., Arthritis interferes with steady and safe movement.)
  • Taking certain medicines that may lead to bone loss. e.g., steroids.
Dr N Somasekhar Reddy is Consultant Orthopaedic Surgeon, Apollo Health City ,Hyderabad

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