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A hip fracture, or broken hip, is most common after the age of 65. This usually occurs because bones gradually lose minerals and become less dense as a consequence of aging. This process, called osteoporosis, can weaken bones, making them more likely to break. Though a hip fracture at an older age can be especially dangerous, surgery usually offers the patient an effective treatment option. If the patient has other health problems that make surgery too dangerous, non-surgical treatments may be used.
A hip fracture is most often treated using orthopedic surgery, a type of surgery focused on the bones of the body. Hip fracture repair surgery can be especially stressful for older patients, who may require lengthy recovery periods. Orthopedic surgeons often prescribe physiotherapy, also known as physical therapy, to help the patient become active as soon after the completion of the surgery as possible.
There are several types of hip fracture repair surgery available, depending upon the age of the patient, the exact location of the fracture, and the severity of the fracture. Femoral neck fractures, for example, can be repaired three different ways. The first method is called internal fixation and involves an insertion of metal screws into the broken parts of the hip, to hold them together while they heal. This method is usually only used if the bone remains properly aligned after the fracture.
Hemiarthroplasty may be the treatment method of choice, however, if the ends of the bone in a femoral neck fracture are not properly aligned. With this method, the orthopedic surgeon can replace the head and neck of the femur with a metal prosthesis. Many patients prefer this type of surgery, as they may be able to begin to walk without having to wait for healing to occur.
A femoral neck fracture may also be treated with a total hip replacement, which means that the upper femur and the socket in the patient's pelvic bone are replaced with a prosthesis. Patients with joint disorders, such as arthritis, may find this method to be a good option. Older patients are also more likely to receive this surgery, since they have less time to wear out an artificial replacement part or to need additional surgeries in the future.
For a hip fracture involving the area below the neck of the femur, known as the intertrochanteric region, a surgeon usually implants a metal hip compression screw to bridge the break. This screw helps to keep the bone stable. As the hip fracture heals, the bone pieces compress and the edges come together. Such a break typically takes three to six months to heal. Though orthopedic surgery is the mainstay of treatment for hip fractures, if surgery is refused or is not possible, skin traction — also known as Buck's traction — can be undertaken to realigning the bones.
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