Osteoporotic Hip Fractures

Osteoporotic fracture is a result of osteoporosis.

Osteoporosis, which means “porous bone”, is a silent disease that is increasing at an alarming rate. It is a disease where the bone loses its density and quality, resulting in weak bones that fracture easily.

Osteoporosis can affect 1 in 3 women over the age of 50, and 1 in 5 men. It is a silent disease as there are few signs and symptoms, and often only discovered after a fracture has occurred.

Osteoporosis most commonly results in the fractures of the hip, wrist and spine.

Osteoporotic fracture of the hip is a very debilitating injury. Out of every 4 hip fracture patients, 1 does not survive beyond the first year, 1 will become bedridden or wheelchair-bound, and only 2 of the 4 can return to walking, frequently requiring the use of a walking aid like a walking frame.

Osteoporotic fracture - intertrochanteric fracture and fixation
Intertrochanteric fracture and fixation (Image – Courtesy of AOTrauma)

neck of femur fracture
Neck of femur fracture (Image – Courtesy of AOTrauma)

Surgery is indicated in all patients with hip fractures who are fit to undergo surgery. The aim of hip fracture surgery is to reduce pain from the fracture and also to enable to patient to mobilize out of bed early. Surgery should be performed as soon as possible so that the patient can be mobilized quickly to prevent complications like pneumonia and bedsores.

The type of surgery depends on the type of hip fracture. A fracture through the neck of the femur will require a hip replacement surgery, most commonly using a device known as a Bipolar Hip Hemiarthroplasty implant. A fracture at the intertrochanteric region of the hip will require fixation with a metal implant such as an Intra-medullary Nail.

Surgery typically takes around 2 hours and is performed under general or regional anaesthesia. The fixation of an intertrochanteric fracture is done using minimally invasive incisions to minimize the soft tissue damage and for better healing.

X-ray of intertrochanteric fracture before and after fixation
X-rays of intertrochanteric fracture

X-rays of Neck of femur fracture sugery
X-rays of Neck of femur fracture

After hip fracture surgery, patients are started on walking exercises as soon as possible. Every day that the patient spends in bed will require an additional 3 days to get the patient walking. Hence, our patients are started on walking exercises immediately the day after their surgery. It may take 6 to 12 months for the patient to regain their mobility.

It is very important to treat osteoporosis. Nearly 50% of patients with an osteoporotic fracture will suffer another fracture within the next 1 year. If you are over the age of 50, you should check for and treat osteoporosis before you suffer from a debilitating fracture. Should you have any questions, please contact our osteoporotic fracture specialist, Dr Victor Seah today.

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