Question:My mother is in the hospital with a broken hip. The doctor says it might take months for this type of break to heal. She may not get back to full weight-bearing for up to five months. Mom is in excellent health. Why will this take so long?
Answer:There are many different types of hip fractures affecting either the femur (thigh bone) or the acetabulum (hip socket). In older adults, the most common hip fracture occurs in the upper portion of the femur.
A simple fracture through the main part of the bone is straightforward and usually heals well in healthy adults. But fractures affecting the neck of the femur can be quite complex. The femoral neck is a thin bridge of bone between the shaft of the bone and the round head that fits in the hip socket. This type of fracture can cause complications from a loss of blood to the femoral head.
Intertrochanteric fractures are located between the greater trochanter and lesser trochanter. The trochanters are projections of bone on the femur.
The greater trochanter is at the top of the shaft before the femoral neck begins. The lesser trochanter is on the opposite side of the femur and down below the neck. Prognosis for healing is usually good for healthy adults with this type of fracture.
Less often, subtrochanteric fractures occur. These breaks involve the shaft of the femur. They are located just below the lesser trochanter. The fracture pattern may extend down the upper to mid-portion of the femoral shaft.
Surgery is usually required for subtrochanteric fractures. The bone may be broken in several pieces. Plates, screws, and/or nails called internal fixation are used to hold the bone in place until healing takes place.
Some types of internal fixation cannot be stressed or overloaded. This may mean full weight-bearing isn't allowed until X-rays show the fracture is stabilized. The surgeon wants to try and avoid pressure that will cause the fracture to move or the ends of the broken bones to sink into each other.
It might be a good idea to have the surgeon review with you and your mother the exact kind of fracture she has and specific precautions required. Collapse or nonunion of the fracture could delay healing even more.Douglas W. Lundy, MD, FACS. Subtrochanteric Femoral Fractures. In Journal of the American Academy of Orthopaedic Surgeons. November 2007. Vol. 15. No. 11. Pp. 663-671.
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