eMedicine Specialties > Sports Medicine > Hip

Hip Fracture: Follow-up

Author: Naveenpal S Bhatti, MD, Consulting Staff, Department of Emergency Medicine, Hayward/Fremont Medical Centers
Coauthor(s): Janos P Ertl, MD, Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopaedic Surgery, Wishard hospital
Contributor Information and Disclosures

Updated: Jan 30, 2009

Follow-up

Return to Play

As may be expected, each athlete with a hip fracture is treated on an individual basis. To return to play, the athlete should be off all pain medications, be relatively pain free, and have no return of symptoms during sports-specific activities.

Complications

Complications related to poorly treated or misdiagnosed stress fractures are considerable. AVN, nonunion, varus deformity, chronic pain, and completely displaced femoral neck fractures may occur and may lead to serious life-altering changes in function and the patient's ability to ambulate efficiently.

Prognosis

The prognosis for hip fractures is dependent on the age and condition of the patient and on the location and type of fracture. Athletes who sustain femoral neck stress fractures may or may not be able to return to their sport. Tension stress fractures are generally unstable and have an unfavorable prognosis. On the other hand, compression fractures are usually successfully treated with conservative measures and have a good prognosis for recovery. Hip fractures in elderly individuals have a mortality rate of 14-36% one year following surgery.

Education

Patient education is a very important aspect to the rehabilitation process following hip fracture, regardless of the patient's age. Patients must be thoroughly informed about treatment options following their diagnosis, and they must understand the benefits and risks of treatment. If conservative treatment is an option, the patient may need instruction in the use of crutches initially to restrict weight bearing. A physical therapist should be involved in the patient's care for instructions in mobility training and reconditioning of the affected lower extremity. Patients are usually instructed in a home exercise program for continuing strengthening of the hip so that they are able to return to their previous level of activity.

Miscellaneous

Medicolegal Pitfalls

  • Missed fractures or misdiagnosis and a poor outcome or other complications may lead to medicolegal issues.
 


More on Hip Fracture

Overview: Hip Fracture
Differential Diagnoses & Workup: Hip Fracture
Treatment & Medication: Hip Fracture
Follow-up: Hip Fracture
Multimedia: Hip Fracture
References
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References

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  2. DeLee JC, Drez D, eds. Orthopaedic Sports Medicine: Principles and Practice. Vol 2. Philadelphia, Pa: WB Saunders; 1994:1076-80.

  3. Anderson MK, Hall SJ, Martin M, eds. Sports Injury Management. Baltimore, Md: Lippincott Williams & Wilkins; 2000:412-3.

  4. Shin AY, Gillingham BL. Fatigue fractures of the femoral neck in athletes. J Am Acad Orthop Surg. Nov 1997;5(6):293-302. [Medline].

  5. Canavan PK, ed. Rehabilitation in Sports Medicine: A Comprehensive Guide. Stamford, Conn: Appleton & Lange; 1998:265-6.

  6. Davison BL, Weinstein SL. Hip fractures in children: a long-term follow-up study. J Pediatr Orthop. May-Jun 1992;12(3):355-8. [Medline].

  7. Egol KA, Koval KJ, Kummer F, Frankel VH. Stress fractures of the femoral neck. Clin Orthop Relat Res. Mar 1998;348:72-8. [Medline].

  8. Kyle RF, Gustilo RB, Premer RF. Analysis of six hundred and twenty-two intertrochanteric hip fractures. J Bone Joint Surg Am. Mar 1979;61(2):216-21. [Medline]. [Full Text].

  9. Leboff MS, Narweker R, Lacroix A, et al. Homocysteine levels and risk of hip fracture in postmenopausal women. J Clin Endocrinol Metab. Jan 27 2009;epub ahead of print. [Medline].

  10. Shabat S, Nyska M, Eintacht S, et al. Serum leptin level in geriatric patients with hip fractures: possible correlation to biochemical parameters of bone remodeling. Arch Gerontol Geriatr. Mar-Apr 2009;48(2):250-3. [Medline].

  11. Zarin JS, Zurakowski D, Burke DW. Claw plate fixation of the greater trochanter in revision total hip arthroplasty. J Arthroplasty. Feb 2009;24(2):272-80. [Medline].

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Further Reading

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Keywords

hip fracture, femoral neck fracture, intracapsular hip fracture, hip stress fracture, femoral neck stress fracture, femoral stress fracture, Garden classification, Colonna classification, Evan classification, broken hip, fractured hip, cracked hip

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Contributor Information and Disclosures

Author

Naveenpal S Bhatti, MD, Consulting Staff, Department of Emergency Medicine, Hayward/Fremont Medical Centers
Naveenpal S Bhatti, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Janos P Ertl, MD, Assistant Professor, Department of Orthopedic Surgery, Indiana University School of Medicine; Chief of Orthopaedic Surgery, Wishard hospital
Janos P Ertl, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Association, Hungarian Medical Association of America, and Sierra Sacramento Valley Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Gerard A Malanga, MD, Founder and Director, New Jersey Sports Medicine Institute; Director of Pain Management, Overlook Hospital; Director of Sports Medicine, Sports Medicine Fellowship Director, Mountainside Hospital; Clinical Chief, Rehabilitation Medicine and Electrodiagnosis, St Michael's Medical Center; Medical Director, Consultant, Horizon Healthcare Worker's Compensation Services, Blue Cross and Blue Shield Worker's Compensation
Gerard A Malanga, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, North American Spine Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Henry T Goitz, MD, Fellowship Director, Sports Medicine, Department of Orthopedic Surgery, Henry Ford Hospital
Henry T Goitz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine
Disclosure: Nothing to disclose.

CME Editor

Jon B Whitehurst, MD, Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner and Executive Board Member, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital
Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

Chief Editor

Sherwin SW Ho, MD, Associate Professor, Department of Surgery, Section of Orthopedic Surgery and Rehabilitation Medicine, University of Chicago
Sherwin SW Ho, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America
Disclosure: Nothing to disclose.

 
 
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