I found an old diary of my great-great grandfather's (from the late 1700s). Seems his wife was bed bound from a hip fracture -- sounds like the very same kind of fracture my mother has right now. The description was the same anyway. But she's up and walking a week later! What do we know now that they didn't know back then?
Well, of course, today we have the benefit of X-rays to pinpoint the problem, take stock of the severity, and plan treatment accordingly. Not to mention the ability to fix or repair the fracture surgically, which wasn't part of the treatment back in those days.
In fact, according to a recent historical review of the treatment for one particular type of hip fracture (intertrochanteric), hip fractures were treated with "benign neglect" well into the 1900s. In those days, that meant being an invalid or getting around in anyway possible (but not often described).
For those who survived and healed, there was usually a lasting deformity and limp. In many cases, the cause of the hip fracture (e.g., being run over by a carriage) resulted in many other more serious injuries, often leading to death.
Today, we have a wide range of treatment methods including internal fixation (metal plates, screws, and pins to hold the bones together while healing) and total hip replacement. And we have the benefit of 100 years of research into the problem.
We understand the importance of getting the person up and moving as quickly as possible to avoid lethal blood clots or pneumonia. With the aid of supportive devices such as walkers, patients can be out of bed and moving around without compromising the healing fracture site. In fact, earlier problems with screws cutting through the bone have been reduced with the improvement in fixation systems.
It is expected that continued research into better ways of treating various types of hip fractures will continue to yield better and better results. Hopefully, your great great grandchildren will have a very different tale to tell about their ancestor's medical problems.
William E. Albers,MD. Intertrochanteric Hip Fractures: Historical Perspective on Current Treatment Methods. In Current Orthopaedic Practice. September/October 2011. Vol. 22. No. 5. Pp. 405-411.
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