The High Cost of Hip Fractures

Hip Fracture Costs Americans $15 Billion a Year

Hip Fracture

Hip fracture is not only a problem that results in individual pain and suffering but also a problem that costs society a great deal. Hip fracture is more generally a public health problem. Currently, about 300,000 Americans suffer hip fractures each year, and 1.6 million people across the world experience hip fractures each year. This worldwide incidence is expected to double by 2050. In pure financial terms, hip fracture costs Americans $15 billion a year.

Sadly, about 20 percent of people who have a hip fracture die within a year of injury. Fifty percent of people who have hip fracture never regain previous quality of life and live with permanent disability. Furthermore, even among those who live more than a year after hip fracture, the risk of other deadly types of diseases like heart disease, obstructive pulmonary disease and stroke increases. All in all, hip fracture is a pretty horrific injury with life and death repercussions.

Who Gets Hip Fractures?

Hip fractures are pretty homogenous in whom they fall, affecting mostly older white women between 70 and 80 years old. Nevertheless, 20 percent of people who experience hip fractures are men. About 8 percent of people who experience hip fractures are minorities.

What Are the Risks for Hip Fracture?

The following are risk factors that predispose a person to experience hip fracture:

  • age
  • low body-mass index
  • little exercise or physical activity
  • osteoporosis

Nearly half of the people who experience hip fracture have osteoporosis. This osteoporosis weakens bones and makes it easier for a person to fall and break a hip.

Although proton-pump inhibitors (PPIs), like Nexium and Protonix, aren't directly linked to hip fractures, these medications do increase the risk of bone breaks more generally.

How Is Hip Fracture Treated?

Hip fracture involves a break in the proximal head of the femur (think hip ball-and-socket joint), which is the longest bone in your body. About 95 percent of the time, a person experiences hip fracture after a fall. Long bone breaks are exquisitely painful, and femur fractures are no different. These patients are given both regional nerve blocks and parenteral (intravenous) anesthetics for emergent pain relief before surgery.

Any person who experiences a hip fracture should quickly receive hip replacement surgery. Hip replacement or arthroplasty involves an orthopedic surgeon cleaning out the bone from the joint and replacing the hip joint with a hardened plastic or metal prosthesis.

After surgery, it's imperative to get a person who has experienced hip fracture out of traction and walking as quickly as possible. Prolonged bed rest predisposes a person to lung problems as well as increasing the risk blood clotting and deadly pulmonary embolism.

If a person makes for a poor surgical candidate, nonsurgical treatment can be tried, which entails the long-term use of traction, anticoagulation and rigorous chest physiotherapy as well as skilled physical therapy to prevent bed sores.

The prognosis for nonsurgical treatment is poor. In developed nations, nonsurgical treatment is no longer offered as an alternative to surgical treatment. In other words, if you experience a hip fracture and can get surgery, you get surgery.

If you or a loved one is at risk for hip fracture, the best way to deal with this problem is to prevent it. First, you can take bisphosphonates as well as calcium and vitamin D supplements to mitigate your risk for osteoporosis. Second, you should engage in regular exercise like tai chi. Tai chi helps with both balance and strength. Third, you should take fall precautions in your home like getting rid of excess clutter, installing better lighting and placing grab bars in the tub or shower as well as railings next to the stairs. Fourth, you should get your eyes checked because poor vision contributes to fall risk. Finally, work with your physician to get evaluated for fall risk and have your physician evaluate whether any of your medications predispose you to falls. Maybe your medications can be changed to mitigate fall risk.

Selected Sources

Miller RR, Christmas C, Magaziner J. Chapter 118. Hip Fractures. In: Halter JB, Ouslander JG, Tinetti ME, Studenski S, High KP, Asthana S. eds. Hazzard's Geriatric Medicine and Gerontology, 6e. New York, NY: McGraw-Hill; 2009. Accessed January 27, 2016.

Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. Chapter 105. Hip Fracture. In: Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr.. eds. The Color Atlas of Family Medicine, 2e. New York, NY: McGraw-Hill; 2013. Accessed January 26, 2016.

Continue Reading