According to the Centers for Disease Control and Prevention, more than 300,000 senior citizens—those 65 and older—are hospitalized for hip fractures, each year. The majority of these hip fractures are caused by accidental falls, usually by falling sideways. But those statistics don’t make the actual injury any less scary if it happens to someone you know.
With some preparation and general knowledge on geriatric hip fractures, you can help your spouse or parent get the best possible treatment. Here’s what to expect as you assist your loved one through the process.
What is a geriatric hip fracture?
A hip fracture is a break occurring in the upper-third of the thigh bone (femur) and/or around the hip joint.
Geriatric hip fractures are fractures of the hip sustained by elderly adults, which are often the result of a fall. Unfortunately, we become increasingly susceptible to new injuries as we age—the result of typical physical changes that come with time, such as weakened bones and joints (from conditions like osteoporosis or osteopenia), balance issues and loss of muscle mass.
How do you know if it's a hip fracture?
A physician will help you determine if the hip injury is, in fact, a fracture, once your loved one has sought care. The common symptoms they will be looking for when identifying a hip fracture include:
- Severe hip pain
- Patient’s inability to move the injured leg
- Pain with putting weight on the leg
- An externally rotated leg (the injured leg is turned outward)
- A difference in leg length, with the injured leg laying ½-1 inch shorter than the non-injured leg
How are geriatric hip fractures treated?
Once identified, it is important to begin swift medical treatment for the injured hip: Just because geriatric hip fractures are common injuries does not mean that their treatment is simple. Especially when compared to treatment for younger patients, hip fractures in aging individuals often require a higher complexity of care due to additional health concerns faced by senior citizens.
Geriatric Hip Fracture Treatment Must Be Streamlined for the Best Outcomes. Studies show that receiving treatment for a geriatric hip fracture within 24 hours of injury significantly decreases the risk of complications, resulting in a better outcome for your loved one. Unnecessary delays can significantly increase complications, so the efficiency of treatment greatly influences outcomes by reducing these risks. For this reason, Penn Medicine has created a dedicated, streamlined process to treat geriatric hip fracture patients as quickly as possible.
Our dedicated geriatric hip fracture team spans nearly a dozen medical specialties and disciplines, meaning your loved one will likely be treated by a combination of specialists who bring a unique perspective to geriatric hip fracture care. The specialties include emergency physicians, hospitalists and nurses, pharmacologists, anesthesiologists, orthopaedic surgeons and geriatricians—along with physiatrists, physical therapists and even social workers—ensuring the best possible treatment and recovery. The same dedicated team also meets regularly to review and share their knowledge from recent cases, improve treatment plans, and optimize patient care.
Streamlined Admissions Process and Speedy Treatment
Penn Medicine has created a special geriatric hip fracture hip fracture alert, the only process of its kind for hip fracture treatment in the Philadelphia region, which notifies members of our team when a new patient arrives with a suspected hip fracture so that the patient is admitted for streamlined care coordination. As soon as a patient arrives in the emergency department, the internal geriatric hip fracture team is immediately mobilized to admit and begin caring for the patient.
Transferring to the Hospital of Your Choice
Penn Medicine also streamlines admissions for patients transferring from different hospitals or health systems. Many patients and caregivers are unaware that even if they were initially admitted through another hospital’s emergency department, that they can be transferred to the hospital of their choice for care.
If your loved one has already been brought to another facility and you would like to have them transferred to Penn for their operative treatment, speak with your attending physician to start the process.
Geriatric Hip Fracture Surgery
Upon your loved one’s admission to Penn Medicine, an orthopaedic evaluation will determine their treatment plan and to see if surgery is required.
Before Surgery and Surgical Treatment
Before surgery, the patient is put on bed rest and we detail their treatment plan and surgical processes. They may be sent for some tests, including standard blood panels, x-rays, an electrocardiogram (EKG), cardiac ultrasound (ECHO) and stress tests. During this assessment, your questions and concerns will be answered to ensure that your loved one feels comfortable before surgery. The type of surgery will depend on the location and stability of the fracture, and the orthopaedic surgeon will provide more details as they finalize your loved one’s surgery and recovery plan.
The day following surgery, your loved one will be tired but will already be encouraged to resume basic mobility—which could be as simple as dangling their feet off the edge of the hospital bed or walking. Starting this kind of physical therapy as soon as possible enhances recovery. Your loved one’s doctors, clinical care team and physical therapists will begin daily post-operative visits to check on progress, continuing until they are discharged.
Hospital Discharge, Recovery and Beyond
On the day of discharge—typically the third day after their surgery—patients will ideally be able to bear weight on the affected hip and leg, and will be able to lift themselves out of bed, walking with little assistance.
Your Penn Medicine care coordinator at the hospital will help with preparations for transferring your loved one back home or to a care facility as smoothly as possible. You and your loved one will have been educated throughout the course of their hospital stay for next steps on their recovery, medication, physical therapy and other standard measures that follow geriatric hip fracture surgery.
Recovery From Geriatric Hip Fracture Surgery
Following the hospitalization, your loved one’s recovery process will be focused on mobilization and strengthening. Patients are encouraged to put all their weight on the affected leg with the help of physical therapy, assistive devices and their caregivers. During this time, the pain from the fracture and surgery will gradually improve, and mobility should improve as well. They will see their orthopaedic team two weeks after surgery to remove sutures and also to assess progress. X-rays will be taken at six weeks after surgery to make sure the fracture is healing and further accelerate rehabilitation.
While the goal is to return geriatric hip fracture patients to the level of function they had before their injury, this can be challenging for some in this senior patient population. Encouragement and support from loved ones like yourself and the care team will be important in their recovery process. In most situations, it can take between nine months and one year to fully recover from this type of injury.
If you suspect a senior in your life has a hip fracture, dial 911 and contact your local emergency services for immediate care.