Hip fractures in adults of any age group almost always require surgery. The reason for this is that any fractures around weight-bearing joints require accurate reduction in order to prevent rapid onset osteoarthritis.
Some hip fractures may require hip replacement. This is far more often the case in elderly patients, the aim being to mobilize the patient as soon as possible in order to prevent the onset of medical complications.
Femur fractures in adults always require surgery and they are usually managed with an intramedullary nail, which allows rapid mobilization post surgery.
Hip dislocation usually occurs as a result of high velocity trauma such as a “dashboard injury” in a head-on motor vehicle collision. The hip usually dislocates posteriorly (backwards). Anterior hip dislocations (out the front) are rarer but may occur in horse-riding accidents. Because the hip joint cup is fairly constrained, a dislocation is often associated with a fracture of the rim of the cup. Fracture- or not, a dislocated hip must be reduced as soon as possible (within 8 hours of the dislocation episode). Reduction should take place under general anesthetic with muscle relaxation in order to prevent cartilage damage. Consequences of a dislocated hip include bone death (AVN – avascular necrosis)of the femoral head which may result in accelerated osteoarthritis, acetabular labrum damage (labral tear) as well as hip instability as a result of a fractured acetabular rim. If a hip dislocation is not addressed acutely, an irreducible hip with a high avascular necrosis (AVN) risk results.
