Frequently Asked Questions on Hip Joint Dislocation & Fracture

Hip joint is formed by upper end of femur bone and socket of pelvic bone. The head shaped upper end of femur bone is known as head of femur and socket of pelvis is known as acetabulum. Hip joint is known as ball and socket joint. The ball shape head of femur fits into socket or acetabulum of pelvis.

The hip joint dislocation is either partial or complete separation of head of femur from acetabulum or pelvic socket.

The daily normal hip joint activities like flexion, extension and rotation does not cause hip joint dislocation. Separation of head of femur from acetabulum is prevented during such non-forceful hip joint movements by tough ligaments that are attached to neck of femur and acetabulum, cartilage that surrounds the acetabulum known as acetabular labrum and joint capsule.

Hip joint fracture is classified in following 3 types depending on break or cracks through thickness of bone.

Hairline Fracture- Hairline fracture is superficial and does not crack through the entire width of the bone.

Non-Displaced Fracture- Non-displaced fracture results in bone cracked through entire thickness of bone and maintains the normal anatomical alignment.

Displaced Fracture- Displaced fracture causes separation of two ends of bones. Such fracture causes deformity since separated bone protrudes and forma hard swelling resulting in hip joint abnormality.

Hip joint is formed by head of femur bone and acetabulum of pelvic bone. The ligaments and capsules that supports hip joint are attached to surrounding femur and pelvic bone. Fracture of these bones also affects hip joint movements and thus included in hip joint fracture.

Following fracture are included in hip joint fracture-

• Fracture of head of femur
• Fracture of neck of femur
• Fracture of greater trochanter of femur
• Fracture of lesser trochanter of femur
• Fracture of trans-trochanter bone
• Fracture of pelvic acetabulum
• Fracture of ilium bone

Hip joint fracture is serious condition. The condition like hairline or non-displaced fracture of the hip joint may turn into displaced fracture if ignored and not appropriately treated. The displaced hip joint fracture if not treated may cause the wound to heal with deformity and individual may suffer with moderate to severe pain and deformed lower leg until the deformity and fracture is surgically treated. In few cases infection may follow if open wound associated with fracture is ignored. Infection causes life threatening serious complication if not treated.

Pain- Broken hip joint causes sudden occurrence of moderate to severe pain in groin and over hip joint. The hairline and non-displaced hip joint fracture causes moderate to severe hip joint pain. Displaced hip joint causes excruciating severe pain.

Hip Joint Deformity- Hairline and non-displaced fracture do not cause hip joint deformity. The sudden occurrence of bump or painful swelling over hip joint following fall or abnormal hip joint movements suggests possible displaced hip joint fracture. Occasionally elderly patient suffering with osteoporosis may sustain hip joint fracture with minimum hip joint hyper extension, flexion or rotation.

• Hairline fracture of the hip can heal without surgery if hip joint movements are restricted for 4 to 6 weeks.
• Non-displaced fracture of the hip can heal without surgery if leg is placed in cast to prevent any movements.
• Displaced hip joint fracture should be treated by surgery.

Displaced hip joint fracture is treated with surgery. Surgery involves aligning the two fracture end in anatomical position. The position is maintained by placing either rod through the bone or plate on the side of adjacent bone.

Hairline hip joint fracture causes mild to severe pain. Non-displaced fracture of the hip joint causes moderate to severe pain. Displace hip joint fracture causes severe excruciating pain and pain intensity increases with any hip joint movements.

Broken hip resulting in displaced fracture causes severe excruciating pain. The compound hip joint fracture can be life threatening. The compound fracture is displaced hip joint fracture which results in separation of two ends of bone as well as exposure to atmosphere through open skin wound. The open skin wound causes infection that spreads into blood and causes life threatening condition known as bacteremia that spreads through blood into all the organs. The condition also causes rupture of femoral artery by sharp edge of broken femoral bone. Severe blood loss can be life threatening.

One cannot walk on a broken hip joint. The walking can cause separation of two ends of broken bones and that may results in damage of surrounding tissue.

Fracture is also known as cracks or break in the bone.

Yes, hip joint fracture is an emergency condition. Immediate diagnosis as well as treatment is essential to prevent complications and further damage to surrounding blood vessels and nerve fibers. The open hip fracture should be treated and isolated to prevent any infection of the joint. Bleeding from surrounding rupture blood vessels may need to be treated by surgery to prevent further blood loss and surrounding tissue damage.

Elderly individual often suffers with osteoporosis. Healing of hip joint fracture takes longer time in individual suffering with osteoporosis. Elderly person if not suffering with osteoporosis may recover from broken hip in 6 to 8 weeks after surgery or following conservative treatment if fracture is hairline or non-displace hip joint fracture.

Hip fracture itself does not cause dementia. Elderly person suffering with mild dementia that was not diagnosed may show worsening of symptoms. Dementia symptoms in such cases is observed because of suffering with severe pain and side effects from medications. Opioid and antibiotics prescribed for pain and infection in such cases may induce symptoms of dementia.

Most patients are kept for 1 to 3 days following hip joint surgery depending on extent of surgery. Occasionally patient suffering with compound fracture may be observed and treated in hospital for 5 to 7 days. Elderly patients suffering with cardiac and respiratory illnesses may need longer stay and intensive care admission.

Majority of healthy individuals of age between 18 and 60 are kept for 1 to 3 days in hospital after hip joint surgery.

Individual is advised complete bed rest for 5 to 7 days after hip surgery. Bed side physical therapy is resumed after 48 hours either at home or in hospital. Patient is encouraged to stand after 5 to 7 days depending on pain tolerance. Patient may be able to take few steps in 7 to 10 days. The patient may be able to performed normal walk following 8 to 12 weeks.

Fracture is common in elderly patient suffering with osteoporosis.¹

The published data suggests 1.66 million individuals fractured hip joint in 1990.²

Similarly, another published data suggests among population of 100,000 individuals hip fracture is observed in 104 patients. Such fracture is observed twice more often in females than males.³ Among children clavicle and upper arm fracture is common. Hip joint fracture is more often seen in patient following Automobile accident. Hip fracture is common among patient suffering with epileptic disease.⁴

NOF is the term used for neck of femur fracture.

References:  

Also Read:

• What Can Cause Hip Joint Pain and How Is It Diagnosed?
• Hip Joint Septic Arthritis: Causes, Symptoms, Treatment, PT, Surgery
• Hip Joint Dislocation: Causes, Types, Symptoms, Treatment
• Hip Joint Fracture: Classification, Types, Causes, Symptoms, Signs, Treatment
• Hip Joint Arthritis: Types, Causes, Signs, Symptoms, Treatment, Surgery, Diagnosis, Risk Factors
• Frozen Hip Joint: Causes, Symptoms, Treatment, Exercises, Recovery
• What is Hip Joint Abscess: Causes, Symptoms, Treatment, Physical Therapy, Complications