Saturday, May 17, 2014

COMPLEX FRACTURES OF HIP

Fractures are defined as break in the continuity of bone caused by forces that are stronger in strength than tissues in the bone. Bone fractures are classified into two major categories- simple fractures and compound or complex fractures. Simple fractures, also called closed fractures, are broken bones that remain within the body and do not penetrate the skin. Complex fractures, also known as open fractures,are fracture where bones are severely damaged at multiple places.This often produces damage to the surrounding tissues and penetrates the skin overlying the bone,exposing the inside of the limb to the external environment.

 Hip fractures or pelvic and ace tabular fractures are some of the most serious injuries treated by Dallas orthopedic surgeons. After a motor vehicular accident or a bad fall in an elderly patient, due to osteoporosis,pelvic fractures are commonly encountered. Patients with fractures of the pelvis and incunabulum typically experience injuries to the surrounding tissues i.e. skin and muscles and cardiovascular structure such as arteries, nerves and veins. Significant bleeding and a risk of nerve damage are associated with hip fractures.Complex fractures are generally diagnosed on X-rays, CT scan and MRI.

 Treatment includes initial control of bleeding and pain as well as stabilization of the fracture by using an external frame to temporarily hold the bones in proper alignment. This is called as ‘temporary external fixation’ by using screws or metallic plates. Permanent realignment of the bones is done by a technique called as ‘open reduction’ in which an incision is made or by ‘closed reduction’ which is performed without any incision. After realignment, the surgeon uses internal or external fixation methods to hold the bone in a proper position using metallic wires, screws and plates. Generally, patients with a complex fracture of the hip require open reduction with internal fixation.

Major potential complications following surgery are blood clot formation, loss of blood supply to the head of the femur due to disrupted blood flow.Finally, important branches of sacral and lumbar nerves might get affected resulting in a neurological deficit.Rehabilitation and physiotherapy play an important role post-surgery. Planned and customized physiotherapy is necessary for a quick and complete recovery from a complex fracture of the hip joint.

After all, if you want to hop, you need a stable hip!