Fracture of the hip joint
One of the largest joints in the human body is the hip. It performs important functions when moving, since it is on it that the main load falls when walking, running, jumping. With a fracture of the hip joint, the collar of the femur is damaged. It connects the head, located in the acetabulum, to the body of the bone. The hip joint is surrounded by large muscles. The friction of the articular surfaces against each other is eliminated by the cartilage covering the head.
The blood supply to the femoral neck area occurs through a large number of vessels. They are located in the capsule of the joint, inside the bone and ligament of the head. The fracture damages not only the femur itself or the femoral neck, but also the vessels. Due to circulatory disorders, bone fragments disappear. This phenomenon is known in medicine as osteonecrosis.
Lack of normal blood circulation can cause the fracture to heal. Such cases are not uncommon among elderly patients. This is due to the fact that with age, the vessel inside the head of the joint becomes thin and eventually ceases to function. That is why a hip fracture is much more dangerous for older people than for young people.
Patients after 65 years of age have a hard time tolerating the rehabilitation period. If the operation is not performed on time, prolonged treatment and bed rest provoke an exacerbation of concomitant diseases and lead to death. Women are more prone to hip fractures than men.
Content:
- Causes of a fracture of the hip joint
- Symptoms of a hip fracture
- Types of hip fractures
- Diagnosis and treatment of hip fracture
Causes of a fracture of the hip joint
- In older people, damage to the hip neck is associated with osteoporosis, which is a decrease in bone strength. In women, this phenomenon occurs after the onset of menopause. A simple fall is enough for an osteoporotic fracture.
- Damage to the hip joint is also facilitated by a lack of calcium, which is a consequence of an unbalanced diet, poor eyesight, malignant tumors, and lack of physical activity.
- For young people, the most common causes of this injury are car accidents and other situations in which too much stress is placed on the femoral neck.
Symptoms of a hip fracture
A hip fracture is accompanied by pain that is most noticeable when trying to make any movement with the leg. In a state of rest, the patient's damaged joint is practically not disturbed. You can identify a hip fracture by tapping the heel. In this case, there should be pain in the groin and directly in the area of the injured joint.
If during the fracture there is a displacement of bone fragments, the deformation of the leg will be outwardly noticeable. It is shortened or lengthened. Most patients suffer from the symptom of a "stuck heel" or a symptom of Girgolava, that is, they cannot independently raise their leg, tearing the foot off the surface of the bed, and keep it in weight.
If you do not help the victim in time, a hematoma will form at the site of the fracture of the hip joint in a few days. The outer edge of the foot is pressed against the surface when the patient lies on the bed. This position indicates damage to the femoral neck.
Types of hip fractures
In accordance with the anatomical features, the following types of hip fractures are distinguished:
- Basiscervical. The site of damage to the femur is removed from the head of the joint.
- Transcervical. In this type of fracture, the femoral neck is damaged.
- Subcapital. The area around the head of the joint is injured.
- Capital. It falls directly on the head of the thigh.
Depending on whether bone fragments are displaced during injury, several degrees of fractures are distinguished.
The classification allows you to define specific treatments for different cases. The significant remoteness of the fracture site from the femoral head allows for a favorable prognosis. The chances of maintaining normal circulation in the damaged area are quite high. If the head is touched, it can cause non-union or lead to serious complications. This situation is especially dangerous for elderly patients, whose blood circulation is often impaired.
On the subject: Pain in the hip joint: what to do?
Diagnosis and treatment of hip fracture
The presence of a hip fracture is determined using X-ray. This is the main diagnostic method. In some cases, they resort to computed tomography. It allows you to identify concomitant diseases.
Initially, the only way out for a hip fracture was to immobilize the limb, fix it, and conservatively treat it. At the same time, the fusion of bones was difficult, accompanied by various complications. Over time, other methods of treatment began to be used, including surgery. This is the most effective way to help a patient with a hip fracture.
The conservative method is used in rare cases when, for some reason, it is impossible to perform an operation, for example, in people aged or after a heart attack. For elderly patients, bed rest is often the cause of death, since lack of movement contributes to the exacerbation of various diseases, and digestive problems arise. Congestive pneumonia is one of the possible complications. It causes respiratory distress that leads to death. Decubitus ulcers cause significant discomfort to patients who are forced to stay in bed. You can avoid their appearance by providing the patient with good care, constantly maintaining the purity of the body and changing its position.
Young people also have a hard time tolerating conservative treatment. Prolonged immobilization of the joint can lead to dysfunction and subsequent disability. Therefore, it is so important to carry out the operation and a quick recovery. The patient should start walking independently as soon as possible. At the same time, the rehabilitation period is of great importance, during which it is necessary to perform pull-ups with the help of special belts, do breathing exercises and follow a diet.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
