Unfortunately, your elderly loved ones are weak and prone to accidents and several health conditions, especially a broken femur.
To briefly explain, a broken femur is a fracture or break on the hip or lower extremities.
This condition is potentially life-threatening to older adults. Often, a broken femur leads to health complications or, worse, death.
Broken Femur: A Brief Overview
There are common symptoms that you can observe if an elderly patient is suffering from a broken femur.
But, a doctor’s diagnosis is essential in identifying which type of fracture the patient suffers from. This can help in knowing the appropriate treatment for their condition.
Types of Femur Fractures
The fracture is called a proximal femoral fracture (hip fracture) if it affects the femoral head, neck, or the greater trochanter.
If the femur breaks near the knee, it’s called a supracondylar femur fracture.
On the other hand, femoral shaft fractures occur when the inflicted area is in the middle.
Risks of Getting Broken Femur in the Elderly
The femur, or the bone of your thigh, is one of the strongest bones in your body. And often, this does not easily break.
Younger people likely get broken femurs due to SEVERE ACCIDENTS like car crashes or extreme sports.
However, older adults have a higher risk of getting their bones broken. They can get a broken femur by falling while standing because their bones are frail.
Aside from fragility, factors contributing to the risk of the elderly getting femur fractures or a broken hip include:
- Lack of Physical Activity
- Smoking cigarettes
- Heightened risk of falling
A person’s bone relies on its building blocks – calcium – to make it stronger and denser.
However, the production of calcium deteriorates as a person grows older. This, in turn, causes osteoporosis – a condition characterized by the loss of bone density.
This makes older adults prone to fractures because their bone density decreases.
Lack of Physical Activity
Regular physical activity can help strengthen the muscles and bones, including the femur.
Weight-bearing exercises can help in building more muscle and bone tissues.
However, a person who lives an inactive lifestyle tends to have WEAKER bones and muscles.
Older adults are already weak and can no longer sustain intensive physical activities. Hence, they are exercising their bodies less.
Cigarette smoking is closely related to complications in the respiratory system. However, such a habit can also increase one’s risk of fractures.
Blood vessels can shrink due to the chemicals introduced through smoking.
The tissues in your bones and muscles are consequently denied enough oxygen and nutrients, including calcium which is the major building block of bones.
Like osteoporosis, this can also lead to a decrease in bone density and cause the bone to be weak.
Heightened Risk of Falling
The elderly also have an increased risk of falling.
This could be due to health conditions like poor vision and joint diseases. They also have poor balance than younger adults.
The elderly with mental disorders, such as dementia and Alzheimer’s, are also at risk for accidents.
You also need to consider the environment where the older adult resides. Hazards in the home or nursing facilities include the stairs, wet floor, and the absence of railings.
Symptoms of a Broken Femur in the Elderly
After getting into a severe fall or accident, an elderly is likely to get a broken femur.
If you are caring for an older adult, the following symptoms can signify that they have a broken femur:
- Extreme pain
- Unable to put weight on the affected leg
- Pieces of the bone push up or pierce through the skin
- Bruised or swollen thigh
- The injured leg may appear shorter and dislocated
For femoral neck fracture, the patient might experience:
- Worsening pain in the groin when rotating or putting weight on the hips
- The leg on the affected hip appears short and can easily be rotated
- The knee faces outward
Diagnosing a Broken Femur
Often, healthcare providers require X-rays or Computed Tomography (CT) scans if necessary.
These tests are essential for experts to determine the type of breaks or fractures the patient suffers from. This aids in creating an appropriate treatment plan to treat the condition.
Through X-rays and CT scans, doctors can identify the following common breaks:
- Open fracture
- Spiral fracture
- Oblique fracture
- Transverse fracture
- Compound fracture
- Comminuted fracture
How Serious Is a Broken Femur in the Elderly?
A broken femur is dangerous and potentially life-threatening. Fracture incidence involving the femur can lead to:
- Severe blood loss
- A broken hip or hip fracture
- A broken knee or knee fractures
Infections are also one of the major risks of femur fractures.
This could develop with bacteria penetrating through the broken skin. Elderly patients might also get an infection after surgical treatment.
To determine if a patient caught an infection, the following signs and symptoms can be seen:
- Rapid heart rate
- Increased blood cell count
- Redness of the affected limb
Long-Term Effects of a Broken Femur
The femur is the largest and strongest bone in your body. And it’s one of the main bones used in walking.
Hence, breaking your femur can hinder you from doing daily tasks, especially those that involve walking.
Aside from this, patients with hip and femur fractures can develop several complications that affect their quality of life. These include:
- Acute Compartment Syndrome (ACS) – causes permanent nerve and muscle damage
- Abnormal healing of the connected bone ends
- Irritation from locking screws and nails
- Fat Embolism Syndrome – introduces fat to the bloodstream leading to shortness of breath or unconsciousness
- Damaged nerves and blood vessels
Treatment for Broken Femur in the Elderly
The primary medical treatment provided by healthcare providers is surgery. This is essential to ensure that the bone heals properly.
Surgery is performed 24 to 48 hours after the elderly patient breaks their hip or femur.
Typically, your doctor would perform Open Reduction and Internal Fixation (ORIF) or External Fixation.
A splint is sometimes used to temporarily stabilize the patient’s affected limb and manage the pain.
The two types of traction used to temporarily treat a broken femur are:
- Weighted traction splints. This involves putting a strap on the ankle. These straps use weights attached to a frame or pulley to introduce a gentle pressure on the affected area.
- Skeletal traction. This involves a surgical procedure to insert a pin in your tibia or femur. These pins are attached to a weight to aid you in keeping the limb straight.
Surgery for Broken Femur in the Elderly
Orthopaedic surgery refers to the procedure concerned with the musculoskeletal system.
The specialized experts who perform the procedure are orthopaedic surgeons. They are trained to handle all areas of orthopedics, including fracture care and trauma.
There are several types of surgery used in treating fractures. Such a procedure can either be internal or external.
This is performed to keep the bone in place while it’s healing.
As previously mentioned, there are two types of surgery that healthcare providers commonly perform to treat fractures:
- Open Reduction and Internal Fixation (ORIF)
- External Fixation
Open Reduction and Internal Fixation (ORIF)
In an ORIF procedure, the doctor makes an incision at your hip or knee area (depending on the fracture).
This is done to fractures that can’t be treated with splints or casts.
Health experts will recommend the patient for such an urgent type of operative treatment in cases where:
- There are multiple breaks on the bone
- The bone moves out of its original position
- The bone is piercing out through the skin
During ORIF, the surgeon will line up the broken bones and secure them. Often, they use rods, screws, and metal plates to stabilize the broken bones.
On the other hand, external fixation secures the bones from the outside.
Doctors usually use bolts to stabilize the broken bones on the frame of the femur.
Such a procedure is necessary if the patients with hip fractures can’t undergo ORIF immediately due to certain limitations.
Recovery of Femur Fracture in the Elderly
Surgery aftercare is equally important as the pre-treatment and treatment procedures.
After the geriatric hip fracture surgery, geriatric hip fracture care is essential in decreasing the time of being bedridden.
Formal physical therapy is helpful for geriatric hip fracture patients and femur fracture patients.
Physical therapy from accredited healthcare providers can help in the early mobilization of the elderly patient.
This, in turn, can help you avoid complications that come with long periods of immobility.
Broken Femur and Elderly Death
With the existing comorbidities of elderly patients, they are at high risk of dying due to femur fractures.
Broken femur and hip fractures have been a major cause of postoperative complications among elderlies. Often, these complications may lead to death.
Broken Femur Elderly Mortality Rates
Literature shows that mortality rates among older adults vary.
- 30 days after the surgery, the mortality rate is at 6%.
- At 6 months after the procedure, increased mortality is seen at 18%.
- A year after surgery, mortality rates escalate to 25%.
- After 9.8 years, experts identified a 38% mortality rate among the elderly without medical comorbidities.
The study also revealed that patients with periprosthetic distal femur fractures have HIGHER mortality rates than non-prosthetic fractures.
A distal femur fracture is mainly associated with higher rates of local complications such as non-union and malunion.
Hip fracture surgery among the elderly also showed a higher mortality rate within the first month of surgery.
A delay in hip fracture treatment has been associated with postoperative mortality and morbidity.
Hence, proceeding with hip fracture surgery within 24 to 48 hours is essential.
Indeed, having fragility fractures caused by a broken femur is something you wouldn’t want your beloved elderly to experience.
That is why you need to start being proactive if your loved one begins to experience pain or discomfort in any of their joints.
The sooner you can address such issues, the easier it will be for you to avoid this condition.