About Physiatry

About Physiatry

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Hip Fracture

Condition: A hip fracture refers to a break in the upper part of the femur (thigh bone).

Background: Many elderly patients fracture their hips due to falls. Therefore, fall prevention is crucial in the prevention of hip fractures. Balance training has been shown to be the best exercise to prevent falls.  Additionally, a younger patient may suffer a hip fracture in a car accident or other trauma.

Risk Factors: Osteoporosis, which results in fragile bones, is present in the majority of patients with hip fractures.  Other risk factors include: the use of many medications, difficulty walking, thinking difficulties, alcohol abuse, tobacco use, disorders involving nerves, and an unsafe home environment (loose rugs, clutter, poor lighting, wet surfaces, or exposed cords).

History and Symptoms: Most patients who have sustained a hip fracture report hip or groin pain after a fall.

Physical Examination: The physician will look for bruising, swelling and stiffness around the hip. Additionally, the injured leg might appear shorter and rotated in an abnormal position at rest.

Diagnosis Process: X-rays will identify the majority of hip fractures.

Rehab Management: The choice of surgical repair will depend on the type and location of the fracture.  After surgery, patients will be encouraged to begin to move in and out of bed, initially with the assistance of the nursing and rehabilitation staff.  Depending on the type of surgery performed, the patient will be instructed on safety with walking and safety within the home.  This may include education about how much weight to put on the leg, what positions to avoid and the use of any specialized equipment. The physical medicine and rehabilitation (PM&R) physician will work with a group of specialized health care workers that may include nurses, physical therapists, occupational therapists, social workers, and case managers to help patients successfully recover from the fracture, regain the ability to walk safely, and prevent future falls. The PM&R physician can manage pain, and prevent complications from surgery including blood clots and infections.

Other Resources for Patients and Families: The patient and caregiver must understand all precautions and restrictions, and how to be safe at home while recovering. If the patient is older with dementia, rehabilitation can be challenging. The Alzheimer’s Association offers resources that may help. 

 

For Patients and Families:

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