Long-Term Care Nurse’s Guide to Hip Fractures

• Learn the specifics of treating hip fractures in elderly patients from the perspective of a Long-Term Care Nurse. 
• Understand the common causes and risk factors associated with hip fractures in elderly patients, including lessening bone density and medication interactions. 
• Review preventative measures nurses can take to protect against hip fractures and treatments, including surgical intervention and physical therapy. 

As people age, the risk of falls and injury increases, and according to the Centers for Disease Control, hip fracture injuries are identified as one of the most serious healthcare problems affecting the older population.  

Hip fractures often lead to decreased mobility, reduced quality of life, and eventual death. This article will guide nurses caring for the aging population on how to handle hip fractures effectively.  

Definition of a Hip Fracture 

A hip fracture is a type of injury that occurs when the ball at the top of the thigh bone breaks off from the shaft and moves out to one side usually into or near the groin area. When this happens, the patient may feel a sudden pain in their hip joint, as well as tingling and numbness down the leg.  

Causes and Risk Factors for Hip Fracture 

Causes

As mentioned above, the most common cause of hip fracture is a fall. Multiple medications, balance, and vision problems all lead to an increased risk of hip fractures, which ultimately leads to an increase in falls.   

Risk Factors

The risk factors for hip fracture include the following: 

• Advanced age: bones become less dense, making fractures occur quicker. 
• Previous hip fracture: patients who have already had one hip fracture are two to three times more likely to experience a second hip fracture. This is because they have less bone density, making them more vulnerable to injury.  
• Certain medications: corticosteroids and anticonvulsants can weaken the bones and increase the chance of fracture.  
• Diseases: osteoporosis, rheumatoid arthritis, and bone cancers. Some diseases related to bone health are osteoporosis, rheumatoid arthritis, and bone cancers. 
• Unhealthy diet and lack of physical activity: insufficient physical activity can make the bone less able to support someone if they fall. A poor diet will lead to lower bone density which also increases the likelihood of falls and injuries such as hip fractures.  
• Menopause:if the patient has been through menopause, they are at risk of osteoporosis which weakens the bones. 

Symptoms of a Hip Fracture 

The following symptoms are commonly seen among those with a hip fracture:  

• Inability to get up from fall or inability to walk. 
• Severe pain in the groin or hip. 
• Inability to put any weight on the affected side. 
• Bruising or swelling on the affected side. 
• Shorter leg on the affected side. 
• Outward turning of the leg on the affected side. 

Prevention Measures and Treatment of Hip Fracture  

Prevention Measures

• Keep patients active and ensure they are eating a balanced diet. 
• Help the patient stay at a healthy weight to prevent more stress being put on the bones. 
• Encourage the patient to wear non-slip footwear and provide non-slip mats for the bath and shower to help prevent falls. 

Treatments

Treatment typically involves surgery. Most hip fractures would heal on their own without surgery, but the issue is the patient would be in bed for eight to twelve weeks.  

Placing an elderly patient in bed for this amount of time has a greater risk of creating severe complications than the more significant would create. Surgery should be performed within twenty-four to forty-eight hours after the injury to promote positive health outcomes.  

The longer the delay in treatment, the more unfavorable the prognosis for the patient. After surgical treatment of the fracture, physical therapy will likely be ordered.  

Potential Complications of Hip Fracture  

The complications that can develop after a hip fracture are what make the injury life-threatening. Most of the complications that occur after hip fracture result from having to put the older patient on bed rest. Getting the patient out of bed and moving can decrease the risk of these complications.  

Complications can still occur after surgery, but they are more treatable if the patient can be mobilized. Some of the more common problems that a hip fracture can increase the likelihood of are: 

• Pneumonia 
• Bed sores 
• Blood clots 
• Mental confusion 

The Bottom Line

In conclusion, a hip fracture is a serious injury with significant consequences. This debilitating condition must be treated quickly to promote positive health outcomes in older patients.  

Surgical treatment of hip fractures can improve a patient’s quality of life and provide better survival and functional outcomes than non-surgical treatment. Close patient monitoring and strict adherence to all fracture treatment plans are essential for the nurse caring for a patient with a hip fracture.  

All these interventions, combined with consistent coordination involving all members of the patient’s healthcare team, will improve the patient’s quality of life and ensure proper healing.  

Read More