This is an automatically translated article.
The article is professionally consulted by Master, Doctor Le Anh Viet - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital
A hip fracture is a serious type of injury that carries the potential to cause potentially life-threatening complications. The risk of hip fracture increases with age, especially in people with osteoporosis. Some medical techniques that help diagnose hip fractures are commonly used, such as X-rays or MRI films.
1. What is a hip fracture?
Hip fracture is a condition in which a fracture occurs in the hip bone. These lesions are common in the elderly, especially in those with osteoporosis.
Most hip fractures are caused by falls, but in the elderly, even minor trauma such as rolling in bed, getting up from a chair, or walking can lead to hip fractures, often due to osteoporosis. weak bones.
Commonly broken hip bones include:
The femoral head. The femoral neck (below the femoral head). Link transfer. Under the switch. The most common hip fracture sites are sub-femur fractures and transtrophal fractures.
Vị trí gãy xương hông hay gặp nhất là gãy dưới chỏm xương đùi và gãy liên mấu chuyển.
2. Causes of hip fracture
Broken hip bones are often caused by a strong force on the hip such as in a work accident or traffic accident. Anyone of any age can suffer a hip fracture for these reasons.
For the elderly, hip fractures are often caused by a fall while standing. For people with very weak bones (osteoporosis), the cause of hip fractures can be as simple as standing on one leg and rotating the leg.
3. Risk factors for hip fracture
Factors that increase the risk of hip fracture include:
Age: With age, the risk of hip fracture increases, because bone density and muscle mass tend to decrease with age. In addition to the family, the elderly may also experience vision and balance problems that increase the risk of falls. Gender: According to statistics, the frequency of hip fractures in women is three times higher than in men. This is because women lose bone density faster than men. Osteoporosis: Patients with osteoporosis have a higher risk of hip fracture as well as other fractures than the general population. Other chronic conditions, such as: Endocrine diseases, such as an overactive thyroid, can cause bones to thin. Several other diseases can affect the brain and nervous system, such as: Parkinson's disease, stroke and peripheral neuropathy. In addition, low blood pressure and low blood sugar can also be a risk factor for falls, which can lead to hip fractures. Use of drugs: Cortisone drugs (Prednisone) if used for a long time can weaken bones. Drugs that act on the central nervous system, antipsychotics and tranquilizers are most commonly associated with falls. Nutritional disorders: A deficiency of calcium and vitamin D in the diet at a young age can reduce peak bone mass, which in turn increases the risk of overall fractures in later life. Alcohol and tobacco use: Both alcohol and tobacco can affect bone formation and maintenance, causing bone density to decrease.
Rượu và thuốc lá đều có thể là nguy cơ gây gãy xương hông.
4. Symptoms of hip fracture
Signs and symptoms of a hip fracture include:
Inability to get up or walk after a fall. Feeling severe pain in your hip or groin area after a fall. Inability to stand on one side of the broken hip. Swelling and bruising in the hip area and around the hip. When straightening the legs on a flat surface, the leg on the side of the broken hip is usually shorter. The leg on the affected side is rotated outward.
Một trong những dấu hiệu nhận biết gãy xương hông là không có khả năng đứng dậy hoặc đi bộ sau một cú ngã.
5. Complications of hip fracture
Complications of hip fracture include:
Necrosis of the head . Not immediately. Osteoarthritis. These complications are more common in the elderly with displacement fractures of the femoral neck.
Hip fractures can reduce patient independence and sometimes shorten survival time. About half of patients with hip fractures do not regain the ability to live independently.
If a hip fracture leaves you immobile for a long time, you may experience some of the following complications:
A blood clot in your leg or lung. Bedridden with ulcers at pressure points. Urinary tract infections . Pneumonia . Loss of muscle mass, affecting the ability to walk and move later. Dead.
Hoại tử chỏm là một trong những biến chứng của gãy xương hông.
6. Medical techniques for hip fracture diagnosis
Your doctor can diagnose a hip fracture based on your symptoms and abnormal posture of your hip and leg. However, doctors often use a number of additional imaging techniques to accurately diagnose your hip fracture, which include:
Routine X-rays: Can diagnose fractures hips by x-ray film of the pelvis in the upright and slanted position. If a hip fracture is confirmed, an x-ray of the entire femur is recommended. Signs suggestive of a hip fracture may include abnormalities in the density of the femoral neck trabeculae or the cortical bone. However, sometimes pelvic radiographs are normal, especially in patients with subcapsular fractures or in patients with severe osteoporosis. Magnetic resonance imaging (MRI): If the fracture line is not visible on the X-ray film, but there are clinical symptoms of hip fracture, it is necessary to conduct an MRI scan, which is a technique to diagnose hip fracture with high density. signal and sensitivity close to 100%. Computed tomography has a lower sensitivity than magnetic resonance imaging. Most hip fractures occur in one of two locations on the femur:
Femoral neck: Located in the upper part of the femur, at the head of the femur just below the globular joint. Intertropical region: This position is located slightly away from the hip joint, in the upper part of the femur and protrudes outward.
Bác sĩ thường sử dụng thêm một số kỹ thuật chẩn đoán hình ảnh để chẩn đoán chính xác tình trạng gãy xương hông như x-quang, MRI, CT,...
7. Hip fracture treatment
Hip fractures often need to be treated by open surgery, which combines the bones inside. In some special cases, partial or total hip replacement is required.
The choice of surgery depends on the location and severity of the fracture. In addition, it depends on the age, health status and underlying medical conditions of the patient. Surgical methods include:
Surgical fixation, using a brace: Metal screws are inserted into the bone to hold it together and wait until the bone heals. Sometimes metal screws are fixed to a metal plate that runs down the femur. Total hip replacement surgery: This means that the femur and the joint in the pelvis are replaced with artificial parts. An increasing number of studies show that total hip replacement is more effective in terms of better long-term outcomes in healthy and independent adults, as well as in terms of cost-effectiveness. Partial hip replacement surgery: In cases where the ends of the broken bones are displaced or damaged, the surgeon may remove the head and neck of the thigh bone and then install a metal device to replace it. This approach may be recommended in adults with other medical conditions or cognitive impairment or who are not independent. In addition, your doctor may recommend partial or total hip replacement if the blood supply to the bridge of the hip is damaged. This type of injury is more common in older adults with femoral neck fractures.
Trong một số trường hợp, cần phải thay khớp háng bán phần hoặc toàn phần.
8. Rehabilitation in patients with hip fracture
After hip fracture surgery, the patient will need rehabilitation treatment to regain mobility of the hip joint. The medical team will likely assist you in getting out of bed and moving on the first day after surgery. Physical therapy will begin with strengthening exercises and limited range of motion.
You will then need instructions on how to use the restroom, wash, dress, and cook. Depending on the type of surgery, your health condition, the doctor will recommend an exercise program to help you maximize the basic function of the hip bone.
9. Measures to prevent hip fractures
Adopting a healthy lifestyle during adolescence produces higher peak bone mass. At the same time, this also helps reduce the risk of osteoporosis in later years. The same measures that should be taken at all ages can reduce your risk of falls and improve your overall health.
To avoid falls and maintain healthy bones, you need to take the following measures:
Get enough calcium and vitamin D for your body: Both men and women over 50 need 1200mg of calcium and 600 units vitamin D per day; Exercise and improve balance: Practicing weight-bearing exercise, such as walking, will help you maintain peak bone density. At the same time, exercise also increases your overall strength, making you less likely to fall. Balance training is also important to reduce the risk of falls. The ability of each person to keep balance tends to decrease with age; Avoid smoking or drinking too much alcohol: Alcohol and tobacco can reduce bone density. In addition, drinking too much alcohol can affect your balance and make you more likely to fall; Eye exam: Get an eye exam every year or more often if you have diabetes or eye disease; Stand up slowly; Use a walker or walker for the elderly. Patients need to go to a reputable hospital to conduct examination and treatment as soon as there are signs of hip fracture. Currently, Vinmec International General Hospital is one of the leading prestigious hospitals in the country, trusted by a large number of patients for medical examination and treatment. Not only having a modern physical system and equipment, Vinmec is also a place to gather a team of experienced doctors and nurses who will greatly assist in the diagnosis and early detection of abnormal signs of cancer. patient's body. In particular, with a space designed according to 5-star hotel standards, Vinmec ensures to bring the patient the most comfort, friendliness and peace of mind.
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