Long-Term Effects of Hip Fractures in the Elderly

Picture this: You receive a call in the middle of the night — your aging parent has fallen and fractured their hip, a life-altering event that statistically reduces life expectancy and quality of life. This sudden emergency propels you into the complex world of health care and long-term care decisions, potential surgeries, and long-term rehabilitation. Yet, despite its prevalence, hip fractures in older adults are seldom discussed until the situation is dire. 

If you have aging family members, understanding the risks and implications of hip fractures is essential. However, don't ignore the fact as you get older, you become a risk for hip and other health issues.

Over 300,000 people aged 65 and older are hospitalized for hip fractures yearly in the United States, making it one of the most common injuries in this age group. Hip fractures are a serious health issue that can cause long-term damage and mobility issues. They often require surgery and long-term care, which can be costly.

There are several factors that can increase the risk of hip fracture in older adults, including osteoporosis, falls, and certain medications. Osteoporosis is a condition that causes bones to become weak and brittle, making them more likely to break. Falls are the most common cause of hip fractures in older adults. Certain medications, such as steroids, can also increase the risk of hip fracture.

The treatment for a hip fracture depends on the severity of the injury. Stable fractures can often be treated with surgery to insert screws or plates to hold the bone in place. More severe fractures may require a total hip replacement, in which the damaged hip joint is replaced with an artificial joint.

Recovery from a hip fracture can take several months, and older adults may need long-term care, such as physical therapy, to regain their mobility. The cost of long-term care can be high, and many older adults do not have the financial resources to pay for it.

Long-Term Care Insurance can help to pay for the cost of care after a hip fracture. This type of insurance can provide peace of mind for older adults and their families, knowing they will have financial assistance if needed.

Maintain Strong Bones

Learning about preventative measures can help keep bones strong and decrease the risk of falling and becoming injured. Understanding treatment options and what to expect resulting from sustaining a hip fracture can also help minimize pain and make a recovery as efficient as possible. 

Statistics About Hip Fractures

The probability of hip fractures tends to rise in association with age. A broken hip in the elderly becomes more likely for a few different reasons. 

One of the reasons is that the elderly are more likely to fall as they age because their bones aren't quite as sturdy. Older people tend to lose their balance more easily, and they lack the reflexes to recover if their momentum starts to carry them down.

A bone disease such as osteoporosis also increases the probability of a hip fracture because it makes the bones brittle and more likely to break upon impact.

More than 300,000 people age 65 and older are hospitalized for hip fractures every year, and more than 95% of these fractures are caused by a fall. Hip fractures are much more likely to occur in women because they fall more often than men and also develop osteoporosis at a higher rate.

A staggering amount of hip fractures happen in the elderly, with 90% of incidents occurring in those aged 65 or older. The overall incidence of hip fractures has decreased over the last decade but still represents roughly 25% of the geriatric fractures requiring hospital admission. The morbidity and mortality rate also remains elevated.

Risks of a Hip Fracture in the Elderly

Since falls lead to the vast majority of broken hips in the elderly, it becomes necessary to understand why falls happen and how to prevent them. The following video sheds some additional light on the topic - click here. 

According to the National Institute of Health (NIH), scientists have linked numerous personal risk factors to falling. Some of these factors include:

• Weak muscles—notably in the legs
• Poor balance, which can cause difficulty walking and lead to an increased risk of falls
• Sudden drops in blood pressure when getting up from either sitting or lying down
• Dizziness that results from postural hypertension
• Poor vision—not seeing as well as in the past
• Slower reflexes which can lead to difficulty re-gaining balance

Most of these falls occur in the home for various reasons, including clutter, loose rugs, limited access to railings and grab bars, or poor lighting.

Surgery for Hip Fractures

After sustaining a hip fracture, surgery is needed to repair the break. This type of surgery requires general anesthesia or spinal anesthesia. Spinal anesthesia includes injecting medicine into the back to numb the patient below the legs.

The type of broken hip surgery performed will depend on the kind of fracture sustained.

If the fracture has occurred in the neck of the femur, the patient is likely to undergo a hip pinning procedure. To perform this surgery, a doctor will have the patient lie on a table and use an x-ray machine to determine how the parts of the hip bone line up.

The surgeon will make a small incision on the side of the thigh and insert screws to keep the bones stabilized and in their correct position. This procedure typically lasts between 2 and 4 hours.

If the injury is an intertrochanteric fracture, which is the area below the neck of the femur, the surgeon will use a plate and compression screws to repair it.

This procedure is very similar to the one performed when the fracture occurs in the neck of the femur. The only difference is the inclusion of a metal plate and the screws and that the surgery takes less time (2 hours or less).

Full hip replacement surgery may also be necessary if the ball portion of the hip joint was also damaged.

Without undergoing any of these procedures, a person with a broken hip winds up almost entirely confined to a chair or bed due to extreme difficulty in mobility. Bypassing surgical repair is incredibly risky because it can lead to life-threatening medical issues.

Post-Surgical Complications

Although it is far riskier to forego surgery to repair a broken hip in the elderly, there are still quite a few risks attached to having a procedure done. Examples of these risks include:

• Blood clots that may form in the leg veins can break off and travel to the lungs or heart
• Infections can develop at the incision site and need antibiotics. If the infection is significant, it may require additional surgery
• Other fractures may occur in the healthy portions of the hip joint during surgery

Preventing Hip Fractures

Seniors who sustain hip fractures are at the highest future risk of suffering another fracture. Many of these seniors are deficient in vitamin D, and vitamin D supplementation is generally believed to improve bone mineral density and also prevent falls. In addition to vitamin D supplementation, seniors should also look to add supplemental calcium to their daily regimen.

Because such a high rate of hip fractures occurs among the elderly who have osteoporosis, addressing osteoporosis is usually a good strategy for preventing future incidents. Although there is no cure for osteoporosis, these FDA-approved medications are used to treat the condition:

• Bisphosphonates – These drugs create a reduction in the activity of cells that lead to bone loss
• Parathyroid Hormone – Approved for post-menopausal women as well as men with osteoporosis and a high probability of having a fracture
• Calcitonin – Promotes calcium regulation and bone metabolism and is approved for treating osteoporosis in women five years or more beyond menopause
• Estrogen and hormone therapy – Approved for the treatment of osteoporosis in women after menopause

Pain Management

Pain management is a big part of broken hip recovery. Often, the pain level will fluctuate from the period before surgery, the period directly following the operation, rehabilitation, and arriving back home afterward. 

There are numerous options to manage the pain; the most effective choice will depend on the individual and the amount of side effects.

The following are common pain management options:

Acetaminophen

Acetaminophen is a non-aspirin pain reliever used for general pain and soreness. It is unlikely to be strong enough to treat residual post-op hip pain by itself but may be combined with certain medications to augment the effect.

Opioid analgesics

Opioid analgesics are better known as codeine, morphine, and oxycodone. These are much more potent forms of pain relievers and are administered in the form of a pill, shot, or IV.

These drugs can cause side effects such as nausea, vomiting, constipation, sleeplessness, or itchiness.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Common forms of NSAIDs are Ibuprofen and Naproxen. Much like acetaminophen, NSAIDs are not likely to provide enough relief on their own. However, they may be used in addition to other medications (if there are no interactions) or if the pain level is more manageable.

A few common side effects of NSAIDs include dizziness, nausea, and diarrhea.

Nerve Blocks

Nerve Blocks numb the nerves in a localized area using an injected anesthetic medication. A nerve block is usually used when other oral medications cannot be taken and can be more effective than traditional pain medications. For a broken hip, the injection is usually given directly into the hip or groin area.

Acupressure and Muscle-Relaxation Therapy

As a standalone, neither of these treatment options are likely to be sufficient. However, used in conjunction with some of the previously mentioned medications or treatments, these options may help to abbreviate the overall, broken hip recovery time. Another benefit to using acupressure or muscle-relaxation therapies is that there are no side effects or serious risks involved.

Preparing for Changes in Health and Body Essential for Retirement Planning

Understanding why these injuries occur, what you can do to improve your health and avoid them altogether can go a long way in ensuring stronger bones and happiness well into your golden years.

There is no question that as we get older, we see changes in our health. These changes include changes in our bodies. Preparing for these changes is essential to peace of mind and enjoying a more successful future retirement.

Affordable Long-Term Care Insurance should be part of your retirement planning. You will have guaranteed tax-free resources for your choice of quality care, including in-home care. 

You can't stop aging. You can reduce the stress and anxiety your aging will place on your family. Extended health care costs increase every year. Being prepared will not only protect your finances but will protect your family as well. 

Have you or someone you love sustained a hip fracture? Let us know what your experience was like and how you dealt with it in the comments section below on LTC News or here on my blog: https://www.shieldmysenior.com/hip-fracture-in-elderly/