Can an older adult still standing after a fall mean there is no fracture?
Not necessarily. Hip fractures are common among older adults, especially those with osteoporosis, reduced muscle strength or higher fall risk.
Typical symptoms include severe hip or groin pain, the affected leg appearing shortened or externally rotated, and inability to stand or bear weight. However, some people with an incomplete fracture may still manage to stand or walk.
If an older adult has persistent hip pain after a fall, the condition should not be ignored, even if the initial X-ray does not show a fracture. If hip fracture is still clinically suspected, MRI may be considered. If MRI is not available within 24 hours or is unsuitable, CT may be considered.
Why do most hip fractures need early surgery?
The main goals of surgery are to stabilise the fracture, relieve pain and help the patient regain mobility as early as possible.
If the patient is fit for surgery, it should be performed as soon as possible, ideally on the day of or the day after admission. Treatable conditions such as anaemia, dehydration, electrolyte imbalance, heart failure, heart rhythm problems or chest infection should be managed promptly.
Hip fracture care is not limited to orthopaedic surgery. As patients often have other health conditions, a multidisciplinary team should manage pain, nutrition, mobility, cognition, pressure sore risk and discharge planning.
Should patients stay in bed for a long time after surgery?
Generally, prolonged bed rest is not recommended. When the patient’s condition allows, the healthcare team will support early sitting, standing and gradual walking.
Early mobilisation helps restore self-care ability and reduces muscle weakness and other complications related to prolonged bed rest.
What should be noted during recovery?
- Use walking aids and perform mobility training as advised by physiotherapists.
- Ensure adequate energy, protein and fluid intake.
- Assess calcium and vitamin D intake according to individual needs.
- Check eyesight, footwear, home lighting and trip hazards.
- Receive assessment for osteoporosis and risk of further fractures.
- Watch for abnormal signs such as wound problems, persistent fever, shortness of breath, or calf swelling and pain.
Hip fracture may reflect underlying osteoporosis, fall risk or other health issues. Ongoing follow-up after discharge is important, not just waiting for the fracture to heal.
Reference:
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