Fractures of the hip region correspond to those that occur at the upper end of the femur, and with wrist fractures, are the most common in the elderly. Although they are classically divided into two groups; fractures of the neck of the femur and those of the truncal region. In both cases, the problems caused will be similar, since they are usually observed in older people.
These fractures are usually caused by simple falls, largely due to osteoporosis, which is common at this age. In addition, loads that can be three times the weight of the body are supported.
In the hip region, although it is a very resistant area in youth, the effects of osteoporosis will be very visible in the elderly, since the bone trabeculae disappear, sometimes in significant proportions.
Hip fractures are almost twice as common in women as in men, and this is due to the fact that bone loss due to osteoporosis is greater in the female sex.
The frequency of these fractures varies according to countries and geography, with the incidence being higher in northern European countries or the United States in relation to more Mediterranean patients, so it is considered that sun exposure makes an important difference. Along these lines, the incidence is lower in rural areas, where the elderly carry a greater physical load and are more exposed to ultraviolet light.
Which people are more likely to suffer a hip fracture?
If a profile of a hip fracture patient had to be drawn up, it might be as follows: “White female, over 70 years of age, of slim build, sedentary lifestyle and a tendency to repetitive falls. The patient may suffer from chronic diseases, and may be subject to different medications such as sedatives, antidepressants… In turn, there may be a history of osteoporosis and hip fractures in the family.
Generally, it can be said that the number of these fractures has increased in recent years, coinciding with the gradual aging of the population. In the United States, there are more than 200,000 hip fractures per year, in the United Kingdom more than 50,000, and in Spain the figure is around 30,000 cases per year.
Furthermore, it is estimated that by the beginning of the next century, the number of cases could double that of 1980, so that by then, three out of every ten beds in hospital trauma departments could be occupied by elderly people with this problem.
Prevention of hip fracture
The prevention of hip fractures is considered today as a basic point in the health programs of different countries. Currently, the average age of mortality in people who have undergone hip surgery is 75 years.
One of the main goals is to achieve a more effective effect against osteoporosis, applying measures to delay its onset. Thus, a diet balanced in proteins and vitamin D, as well as a sufficient supply of calcium and estrogens, can intervene and function as measures that slow down the loss of bone mass.
At the same time, it is important that the elderly person maintains a daily physical activity, walking -always within their possibilities- and avoiding long stays in bed or even sitting. In addition, a program of estrogen treatment can also be considered, although at this point the collaboration of a specialist in Gynecology will be necessary. However, this treatment should be carried out once menopause has begun.
Prevention of falls in the elderly
Preventing falls in the elderly is important to avoid fractures, and should be of concern not only to healthcare professionals but also to family members.
The chances of falling increase with age, and in fact around 30% of the population over 75 falls at least once a year, and when over 80 years of age, the percentage rises to 50%. As most of their time is spent at home, it is necessary to install handrails or railings in places such as the living room, bedroom or toilet.
Carpets are a hazard for older people, so they should either be well attached to the floor or we should dispense with them. Dark areas are also dark, so lighting is important.
The intake of sedative drugs should also be taken into account, as well as those that cause orthostatic hypotension in patients with a predisposition to falls. In these patients, alcohol and/or tobacco consumption should be avoided, since they favor osteoporosis.