Hip fractures are a serious injury, particularly common among the elderly, where the thigh bone (femur) breaks near the hip joint. In India, the incidence of hip fractures is rising, with an estimated 4.5 lakh cases annually, largely due to an ageing population and increased osteoporosis prevalence.

Prompt treatment is crucial to avoid complications such as loss of mobility and independence. Symptoms include severe hip or groyne pain, inability to walk, and a shortened or outwardly rotated leg.

If you or a loved one experiences these symptoms after a fall or minor trauma, seek immediate medical attention to ensure proper diagnosis and timely management.

Hip fractures are typically caused by a combination of factors that weaken bone strength or increase the likelihood of falls, particularly in older adults. Understanding these causes is crucial for both prevention and management. Here are some common causes of hip fractures:

1. Osteoporosis: Osteoporosis is the leading cause of hip fractures, especially among the elderly. This condition causes bones to become weak and brittle due to a decrease in bone density and mass. The reduced strength makes the bones more susceptible to fractures, even from minor falls or stresses. Women, especially postmenopausal women, are at a higher risk of developing osteoporosis due to the decrease in oestrogen levels, which plays a vital role in maintaining bone density.

2. Falls: Falls are a significant cause of hip fractures, accounting for the majority of such injuries in older adults. Various factors contribute to the increased risk of falls, including poor balance, weak muscles, impaired vision, and the use of medications that cause dizziness or drowsiness. Environmental hazards such as slippery floors, loose rugs, and inadequate lighting also contribute to the likelihood of falls. In the elderly, even a fall from a standing height can result in a hip fracture due to weakened bone strength.

3. Trauma: Trauma from accidents, such as motor vehicle collisions, sports injuries, or significant impacts, can cause hip fractures in people of all ages. While younger individuals with stronger bones may require a substantial force to cause a fracture, older adults with compromised bone strength can sustain fractures from less severe trauma. High-impact injuries typically result in more complex fractures that require surgical intervention.

4. Medical Conditions and Medications: Certain medical conditions and medications can increase the risk of hip fractures. Conditions such as rheumatoid arthritis, hyperthyroidism, and Cushing’s disease can weaken bones. Long-term use of corticosteroids, commonly prescribed for chronic inflammatory conditions, also contributes to bone loss and increased fracture risk. Additionally, medications that affect balance and coordination, such as sedatives, antidepressants, and antipsychotics, can increase the likelihood of falls.

5. Nutritional Deficiencies: Nutritional deficiencies, particularly a lack of calcium and vitamin D, can significantly impact bone health. Calcium is essential for maintaining bone density, while vitamin D helps the body absorb calcium. Inadequate intake of these nutrients can lead to weakened bones and a higher risk of fractures. Older adults are particularly vulnerable to nutritional deficiencies due to reduced dietary intake, decreased absorption, and less exposure to sunlight, which is necessary for vitamin D synthesis.

6. Physical Inactivity: Physical inactivity contributes to muscle weakness and poor balance, increasing the risk of falls and hip fractures. Regular weight-bearing exercises, such as walking, jogging, and resistance training, are essential for maintaining bone strength and density. Sedentary lifestyles, common among older adults, can lead to decreased bone mass and increased fracture risk.

7. Genetic Factors: Genetic factors also play a role in the susceptibility to hip fractures. A family history of osteoporosis or fractures can indicate a higher risk. Certain genetic conditions, such as osteogenesis imperfecta, which causes brittle bones, significantly increase the likelihood of fractures.

By understanding these causes, individuals and healthcare providers can take proactive measures to prevent hip fractures.

Recognizing the symptoms of a hip fracture is essential for timely intervention and effective management. Here are some common symptoms associated with hip fractures:

1. Severe Hip or Groyne Pain: One of the most prominent symptoms of a hip fracture is intense pain in the hip or groyne area. This pain typically worsens with any attempt to move, stand, or bear weight on the affected leg. The pain can be persistent and debilitating, making it difficult for the individual to perform everyday activities.

2. Inability to Walk or Stand: A hip fracture often results in an immediate inability to walk or stand. The affected leg may feel weak and unstable, and any attempt to put weight on it can be extremely painful. This loss of mobility is a clear indication that medical attention is needed urgently.

3. Leg Abnormalities: Visual changes in the appearance of the leg are common with hip fractures. The affected leg may appear shorter than the other leg, and there may be an outward rotation, making the foot and knee point outward. These abnormalities occur because the broken bone disrupts the normal alignment and support provided by the femur.

4. Swelling and Bruising: Swelling and bruising around the hip area can develop soon after the injury. The trauma from the fracture causes bleeding and inflammation, leading to visible changes in the skin and tissues surrounding the hip.

5. Stiffness and Limited Range of Motion: Individuals with a hip fracture often experience stiffness and a significantly limited range of motion in the hip joint. Movements that were once effortless, such as lifting the leg or rotating the hip, become extremely difficult and painful.

6. Audible Snap or Pop: In some cases, individuals may hear an audible snap or pop at the time of the injury, indicating a break in the bone. This sound, coupled with the immediate onset of pain and immobility, strongly suggests a hip fracture.

Prompt recognition of these symptoms is crucial for seeking medical evaluation and treatment.