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Glendale, CA 91206
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Death to the Tip of the Hip

Posted on: 09/18/2002
Hip fractures at any age are serious business. These are most common in adults over 65 years of age. However, younger adults can break their hips, too. Breaks in younger people are most often caused by a serious fall, car accidents, or an activity such as water skiing.

One serious hip fracture occurs at the top of the long thighbone (femur) in an area called the femoral neck. The neck connects the femur to the ball at the top of the hip. The ball is sometimes called the femoral head. A fracture of this type separates the femur from its head. It's called a subcapital hip fracture. If left untreated for too long, loss of blood can occur with death of bone tissue.

The usual treatment for younger adults is surgery to repair the break. Screws are used to hold the bone in place while it heals. Older adults are more likely to have the hip joint replaced.

Doctors want to prevent serious problems like avascular necrosis. This is a loss of blood flowing from the femur through the neck to the head. The head of the femur will collapse and die without enough blood. If the surgery can be done within 12 hours, there is much less chance of blood loss. The longer the surgery is delayed, the greater the risk for avascular necrosis.

Hip fractures in any adult of any age are an emergency. Surgery is usually needed as soon as possible. This will help prevent problems like blood loss to the head of the fumur and resultant death of bone tissue. This is especially true after a subcapital fracture of the femoral neck. In fact, delay in surgery is the number one risk factor for these problems.

References:
Rina Jain, MD, FRCS(C), et al. Comparison of Early and Delayed Fixation of Subcapital Hip Fractures in Patients Sixty Years of Age or Less. In The Journal of Bone and Joint Surgery. September 2002. Vol. 84-A. No. 9. Pp. 1605-1612.

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