Aging; Orthopaedics and Rehab

Why hip fractures require immediate treatment

Aging; Orthopaedics and Rehab

Surgery to repair a hip fracture should be done within 24-48 hours. The longer you wait to get treatment, the weaker and frailer your body becomes.

We live in an aging society; every day, 10,000 people in the U.S. turn 65. Ironically, many people aren’t keen on talking about aging. But members of this older patient population face specific – and often preventable – health risks such as falls resulting in hip fractures.

Increased awareness and conversations about healthy aging are key to reducing these painful, potentially fatal injuries.

Hip fractures in adults over 60 are often associated with bones weakened by osteoporosis, smoking, or chronic use of steroid medications or alcohol. In most cases, fractures are caused by a ground-level fall, meaning the person was standing with both feet on the ground before falling.

The main culprits are usually:

  • Pets: Patients trip over the family cat they didn’t realize was underfoot, or they fall while walking their dog.
  • Walking in the dark or when sleepy: To avoid waking their partner, some patients try to navigate to the bathroom in the middle of the night without a light and trip over items on the floor.
  • Curbs, steps, and throw rugs: Our stride tends to shorten as we get older, making it easier to trip over small, stationary obstacles. Phones haven’t helped matters, either, as more people trip while walking and looking at their smart phone.

Many hip fractures occur in the upper end of the thigh, or femur bone, and require surgery. Too often, patients try to “wait out” the pain instead of seeking immediate treatment – even if they can’t bear weight.

Delaying treatment can lead to serious, even fatal complications. Every patient with a fall-related hip fracture should get it fixed within 24-48 hours.

At UT Southwestern, all patients 60 and older with ground-level fall fractures are automatically cared for through our Returning Seniors to Orthopedic Excellence (RESTORE) program. It’s the only one of its kind in North Texas providing comprehensive care immediately and long after a hip fracture. Patients are treated on a specialized floor by a dedicated team of fracture recovery experts, including surgeons, geriatric specialists, social workers, nutritionists, physical therapists, and bone mineral metabolism specialists.

Depending on the location of the break, our orthopaedic surgeons can replace the whole hip or half of it, or insert a permanent rod inside the bone. While recovery is not painless, the amount of pain and complications are much lower after immediate treatment.

Here are five more reasons to seek treatment immediately if you or a loved one suspect a hip fracture.

1. Pain relief

With any broken bone, sensitive nerve endings in the bones constantly rub together. The intense pain can make patients nauseous and unable to eat. Earlier surgery means faster pain relief. Delayed surgery increases the risk of post-operative delirium – a state of confusion that commonly occurs in older patients after surgery if pain is not managed appropriately.

During surgery, our anesthesia team uses nerve blocks to numb the hip area for an extended period of time after surgery, reducing the amount of narcotics needed. More narcotics increase the risk of delirium.

2. Muscle mass maintenance

If you’re older than 65, you lose up to 8% of your muscle mass every day you lie in bed unable to move. The longer you wait to get treatment after a hip fracture, the weaker and frailer your body becomes. This further reduces quality of life and increases the risk of a future fracture.

Gaining and maintaining muscle mass increases strength and balance, which lowers the risk of falling again. At UT Southwestern, patients meet with physical and occupational therapists once they’re awake after surgery to develop a muscle-building plan. Oftentimes, we encourage patients to stand with a walker not long after surgery and sit in a chair rather than lay in their hospital bed all day.

Weight-bearing exercise, such as walking, is the best way to build muscle and bone strength. Eventually, we might also recommend Tai chi to help improve balance; it incorporates a slow flow of low-impact movements and stretches, combining mindfulness with physical exercise.

3. More effective recovery

Hip fracture recovery takes longer than patients might expect:

  • After four to six weeks, you’ll start to feel less pain and be able to walk further with a walker.
  • Your hip bone will fully heal around three months.
  • Building back your complete leg strength can take an additional six to nine months.

You will start to feel more fully like yourself after a year. However, if treatment is delayed, you might experience more pain, lose more strength, and need a longer recovery period.

After surgery, physical and occupational therapist work closely with patients.

4. Fewer immobility complications

The more time you spend immobile, the more likely you are to develop complications such as pneumonia, bedsores, and blood clots. Illnesses spurred by immobility can further decrease your ability to move, which delays recovery even more.

While most patients stay in the hospital for about four to five days following surgery at UT Southwestern, we make sure you’re up and moving around as soon as possible after surgery, even if it’s just to sit in a chair for a meal. Getting moving is tough at first, but the challenge is worth the long-term benefits and we’ll make sure you have plenty of help.

5. Lower risk of fracture-related death

Many studies have shown that delayed hip fracture treatment increases the risk of death. Worldwide, about 30% of older patients who fracture their hip die within a year of their fracture. It’s usually because the fracture isn’t treated soon enough or they remain sedentary after surgery, causing or worsening other medical conditions.

This is why our RESTORE program is so beneficial. Our process triages at-risk patients to get treatment and receive comprehensive recovery care as soon as possible.

UT Southwestern earned High Performing recognition for treatment of hip fractures from U.S. News & World Report in 2021-2022, placing us among the country's leading hospitals for this area of care. It also recognized UTSW as one of the nation's top 25 hospitals for geriatric care, where we offer our patients proven programs such as the Acute Care for Elders (ACE) Unit at William P. Clements Jr. University Hospital and the UT Southwestern Perioperative Optimization of Senior Health (POSH) Program.

If you fall and suspect a hip fracture, don’t try to tough it out. Seek medical attention right away. We want to help you avoid preventable suffering and enjoy a healthy recovery.

To visit with a geriatrics or orthopedics expert, call 214-645-8300 or request an appointment online.