Hip Fracture Care Guide - NeuRA
Hip Fracture Care GuideA guide for patients,their families and carersLearn how to look after yourbone health after a hip fractureneura.edu.au
Welcome to NeuRA’sHip Fracture Care GuideThis booklet has been put together to helpshine a light on the important steps to followwhen you leave hospital to best support yourhip fracture recovery. It includes basic hipfracture information, treatment options anda guide to osteoporosis planning to supportbone health when you leave hospital.Go online to watch NeuRA’s short talks serieson hip fracture and falls prevention atneuratalks.orgWhat is a hip fracture?The hip is a ball and socket joint where the pelvisand thigh bone (femur) meet. A hip fracture iswhen the thigh bone breaks near where the ballfits into the socket.What causes a hip fracture?Falls are the most common cause of a hipfracture. As we get older, our strength andbalance can reduce and our bones becomethinner due to conditions like osteoporosis.1
This means that we are more likely to falland that even falls from a standing heightcan break a bone.What is the treatment for a hip fracture?Most people need an operation to fix the brokenbone. The main reasons for surgery are to relievethe pain and enable people to get back on theirfeet as soon as possible.The type of operation depends on which partof the hip has been broken.The types of operation recommended fora hip fracture are: A partial or total hip replacement (removingthe broken bone that makes up the ball ofthe ball and socket joint) Screws and possibly a plate to hold thefracture in place A metal rod through the thigh bone(called an intramedullary nail) to holdthe fracture in place2
Who is involved in providing care?If you have a hip fracture, the ambulanceparamedics will be the first members of theteam you meet. On arrival at hospital, the teamof clinicians will include emergency departmentstaff, orthopaedic surgeons, anaesthetists,geriatricians, nurses and physiotherapists.During your admission to hospital, you may alsomeet a pharmacist, pain specialist, occupationaltherapist, dietitian, speech therapist, socialworker and rehabilitation specialist.2.How to Look After Your HipAfter a Fall and FractureHere is a list of the most asked questions andanswers for patients, their families and carers.1.What steps will be taken to manage my pain?Hip fracture pain is felt in the groin and thighand is made worse by movement. Fixing thefracture is often the best way to manage thepain but most people need painkillers to helpmanage pain while waiting for their operation.Paracetamol is commonly used but strongerpainkillers are frequently needed. Constipation isa common side-effect of the stronger painkillersand so you will also be given laxatives if needed.A local injection in the groin called a ‘nerve block’can reduce pain. It can be given in the EmergencyDepartment and can provide pain relief forseveral hours.59% of patients with a hipfracture have a nerve blockbefore their operation.– 2018 ANZHFR Annual Report33.
In hospital2.What happens if I have memory problemsor I become confused in hospital?It is possible that you may become temporarilyconfused following a hip fracture – we callthis delirium. Delirium can be caused by manythings and the most common causes in peoplewith a hip fracture are pain, the anaesthetic,medications including strong painkillers,constipation, dehydration and infection.It is more common in people who already havememory problems. You or your family should letthe ward staff know about any changes to yourmemory or if you have become confused. Promptattention to these issues will enable you torecover sooner.39% of patients with a hip fracturealready have memory problems priorto being admitted to hospital withtheir hip fracture.– 2018 ANZHFR Annual Report3.How long should I have to wait for surgeryonce I am admitted to hospital?The Hip Fracture Care Clinical Care Standardrecommends that your surgery takes placewithin 48 hours of presentation to hospital.This is because it is uncomfortable, undignifiedand distressing to be confined to bed with a hipfracture. This recommended time for surgery may4
not be possible for some patients, for instance,if you have a medical problem that needs to betreated before you have an operation.78% of patients with a hip fracturehave their surgery within 48 hours.– 2018 ANZHFR Annual Report4.How soon after surgery will I be able to get outof bed and start physiotherapy?The aim of the operation is to allow you to getup and put weight through your hip straightaway. Most people are able to sit out of bed andstart to walk the day after surgery. You may feelsome pain or weakness when you start walking.That is very common. Mobilising early will helpyou regain your independence sooner and avoidcomplications, such as pneumonia, clots in thelegs and pressure sores.89% of patients with a hipfracture are given the opportunityto sit out of bed and start to walkthe day after surgery.– 2018 ANZHFR Annual Report55.
At home5.How long before I can go home after surgery?Everybody is different and so it is difficult topredict how long someone will be in hospital.A lot will depend on how you were managingbefore the hip fracture. Some patients progressvery quickly and can go home within 3-5 days.Others will take longer and may need to betransferred for rehabilitation in another wardor hospital.The team looking after you will talk to youabout your progress and work with you toplan for your discharge. They will be happyto involve your family or carer, with yourpermission. It is important for the teamlooking after you to understand your livingarrangements. This will help the planning foryour care and rehabilitation as well as supportyou might require after discharge.14% of patients with a hipfracture are discharged directlyto a private residence fromthe orthopedic ward.– 2018 ANZHFR Annual Report6
6.What can I do to try and reduce my riskof falling and getting another fracture?Hip fractures are usually caused by a combinationof a fall and poor bone quality – osteoporosis.To prevent fractures in the future it is importantto consider your bone health and also fallsprevention strategies.7.How do I look after my bone healthin the future?Osteoporosis is a condition where the bonesbecome thinner and are more likely to break.Calcium and vitamin D are the basic buildingblocks of bone. Dairy products such as milk,yoghurt and cheese, fruit and vegetablesincluding greens, kale, broccoli, potatoes, spinachand tomatoes are good sources of calcium.Canned sardines and salmon are good sourcesof vitamin D, although our main source ofvitamin D comes from sunlight.In addition to calcium and vitamin D, variousbone strengthening treatments are readilyavailable and can be given as tablets or aninjection. These need to be continued overa number of years to protect against futurefractures. Without treatment, one in five peoplewill suffer another hip fracture in future years.An osteoporosis plan should be startedin hospital or should be recommended as part78.
At homeof your bone health plan for the future. You willneed to follow up with your GP after dischargeto make sure you are offered treatment thatwill work for you.Only 49% of patients with a hipfracture leave hospital on calciumand/or vitamin D and 25% arestarted on treatment for osteoporosisbefore leaving hospital.– 2018 ANZHFR Annual Report8.How can I try to prevent a fall in the future?There are many things that can be done toprevent falls. These include exercise, stoppingmedications that can cause falls such as sleepingtablets, monitoring your blood pressure, checkingyour vision and any glasses you may wear, andassessing your home environment.It is important to talk to your GP aboutwhich interventions might be best suitedfor you and to follow up with your GP onyour osteoporosis plan.8
Ask the DoctorMake your osteoporosis plan a priority.Here are five key questions to ask your GPabout osteoporosis:1. What is osteoporosis?2. Do I have osteoporosis?3. Should I have a bone density scan?4. What can I do to improve my bonehealth?5. What treatments are availablefor osteoporosis?9
At homeAdditional InformationAdditional information about hip fracturecare and bone health can be found at thefollowing websites: To learn more about the Australian andNew Zealand Hip Fracture Registry (ANZHFR)go to: anzhfr.org To learn more about the national Hip FractureCare Clinical Care Standard go tandards/hip-fracture-care-clinical-carestandard To learn more about osteoporosis visit theOsteoporosis Australia and Osteoporosis NewZealand websites: osteoporosis.org.au andosteoporosis.org.nzGO ONLINEWATCH FREE VIDEOSon preventing falls and hip fracture careVisit neuratalks.orgThe ANZHFR would like to acknowledgethe support of Neuroscience ResearchAustralia, UNSW Sydney, and the NewZealand Accident Compensation Corporation.10
NeuRA is committed to closingthe care gap to ensure hipfracture patients go home with anindividualised care plan designedto prevent future fractures.NeuRA (Neuroscience Research Australia) FoundationT 61 2 9399 1000 F 61 2 9399 1005Margarete Ainsworth BuildingBarker Street Randwick Sydney NSW 2031 AustraliaPO Box 1165 Randwick Sydney NSW 2031 Australiainfo@neura.edu.au neura.edu.au/hipfractureFollow us on social mediaNeuroscienceResearchAustralianeuraustralia
What causes a hip fracture? Falls are the most common cause of a hip fracture. As we get older, our strength and balance can reduce and our bones become thinner due to conditions like osteoporosis. What is a hip fracture? The hip is a ball and socket joint where the pelvis and thigh bone (femur) meet. A hip fracture is
A hip fracture is a break in the upper part of the femur (thigh) bone. Sometimes an injury can be caused by something as simple as losing your balance and falling. A fall may cause a hip fracture or the hip may break first, causing a person to fall. The hip can fracture in many places. Most often, the fracture occurs in the upper part of the femur.
Fracture Liaison/ investigation, treatment and follow-up- prevents further fracture Glasgow FLS 2000-2010 Patients with fragility fracture assessed 50,000 Hip fracture rates -7.3% England hip fracture rates 17% Effective Secondary Prevention of Fragility Fractures: Clinical Standards for Fracture Liaison Services: National Osteoporosis .
A.2 ASTM fracture toughness values 76 A.3 HDPE fracture toughness results by razor cut depth 77 A.4 PC fracture toughness results by razor cut depth 78 A.5 Fracture toughness values, with 4-point bend fixture and toughness tool. . 79 A.6 Fracture toughness values by fracture surface, .020" RC 80 A.7 Fracture toughness values by fracture surface .
Scottish Standards of Care for Hip Fracture Patients. These standards were initially developed by the National Hip Fracture Advisory Group in 2014 3 and have been subsequently revised and updated as of January 2018. The "Standards of Care" apply to every patient who is admitted to hospital in Scotland after sustaining a hip fracture.
Hip Fracture: Patient Education Handbook AdventHealth - Orthopedic Institute Orlando Understanding the Hip & Hip Fractures Anatomy and Function The hip is a ball and socket joint. The pelvic bone contains the cup shaped “socket” (acetabulum) that holds the “ball” (femoral head). Together they form your hip, and allow
fracture are substantial, accounting for nearly 500 million of health care spending per year in Ontario.1 There is considerable variation in the quality of hip fracture care in Ontario. In the 2014/15 fiscal year, about 20% of patients presenting with hip fracture
What is a fractured Neck of Femur (hip)? This is when the neck (top section) of the thigh bone (femur) breaks. It is also known as a broken hip. This injury normally requires surgery. The diagram below shows the main types of hip fractures: Fracture further below the joint capsule Fracture just outside the joint capsule Fracture within the .
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