Hip fracture repair
Hip fracture repair is a common orthopedic procedure aimed at restoring function and mobility in individuals who have experienced a fracture in the hip joint, typically due to trauma or conditions like osteoporosis. The hip joint, comprising the hipbone and femur, is particularly vulnerable to fractures, especially among individuals over the age of 65, with over 300,000 cases reported annually in the United States. These fractures can occur from falls, sports injuries, or even automobile accidents, and they may also affect sedentary individuals with weakened bones.
The repair process generally involves realigning the fractured bone fragments and securing them with a long nail and a supporting plate to facilitate healing. For more severe cases, total hip arthroplasty (THA) may be performed, wherein the damaged end of the femur is replaced with a prosthetic joint. Advances in material technology have led to prosthetics made from chromium steel alloys and ceramic polymers, designed to last fifteen years or more. Overall, hip fracture repair has evolved significantly, improving the prognosis for recovery and allowing many patients to regain their independence and active lifestyles.
Hip fracture repair
Anatomy or system affected: Bones, hips, joints, legs, musculoskeletal system
Definition: The repair or replacement of a broken hip joint
Indications and Procedures
Hip fracture repair constitutes one of the most common procedures performed by orthopedic surgeons. The human hip consists of two bones, the hipbone and the thighbone (femur), and their point of intersection. This is a cup-shaped cavity called the acetabulum. This hip joint forms a ball-and-socket mechanism that allows the leg to move in different directions. As a major weight-bearing joint, the hip is vulnerable to sudden trauma, such as sports injuries, and degenerative aging disorders of aging, such as osteoporosis. If the loss of bone mass associated with osteoporosis is sufficiently advanced, a simple fall from a standing position can shatter the hip joint. The most common fracture involves the femur snapping or cracking just below the rounded end that fits into the acetabulum.
Perspective and Prospects
In the 2020s, more than 300,000 Americans experience hip fractures on an annual basis. The largest number of these fractures are incurred by persons greater than 65 years of age or older. Many of these injuries are the result of falls in a person’s household. Other conditions besides age associated with hip fractures include gender and osteoporosis. Hip fractures can be associated with injuries stemming from physical activity. These can also result, nonetheless, in non-active, sedentary people whose bones have become weakened from lack of exercise. Stress fractures can result from repeated impacts to the hip and are common in athletes such as long-distance runners. Automobile accidents are another common cause.
The repair of hip fractures involves the realignment of the bone fragments and the insertion of a long nail into the bone to hold them together. A plate is attached to the nail and to the healthy bone surrounding the fracture in order to give support.
Because broken bones heal slowly in the elderly, in the past a broken hip almost inevitably resulted in these patients becoming permanent invalids restricted to wheelchairs or, at best, forced to rely on walkers and enjoying only limited mobility. This bleak prognosis changed in the 1960s, when orthopedic specialists working with biomedical engineers developed artificial hip joints. The combination of prosthetic devices and surgical techniques known as total hip arthroplasty (THA) allows physicians to return patients to active, independent lives. In THA, the weakened end of the femur is removed, and an artificial replacement installed. The replacement can consist of any of a variety of materials, but typically it is constructed of a chromium steel alloy coated with a ceramic polymer that helps resist corrosion and provides a surface with which the patient’s bone can bond. The end of the prosthesis and the surface of the acetabulum are coated with plastic polymers to reduce friction. Research indicates that artificial hip joints last fifteen years or longer before wear and tear on the lining of the ball-and-socket joint creates problems.
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