Hip orthopedy

Hip is the name of the joint between the pelvis and upper part thigh bone, and it is composed of ilium with its circular recess (acetabulum) in which is the head of the femoral, fastened to each other by ligaments.

Hip goes under movable joints, it is the largest and one of the most important joints, as it has a crucial role in the development and preservation of the right architecture of the entire locomotor system, namely statics and body symmetry. Besides that, since it enables movements of the legs in different directions (axis around which movements are performed), it represents a key factor for normal movement and physical activity in general. It is therefore understandable that the prevention of injuries, especially hip fractures, is of particular importance, both from the aspect of health conservation and normal mobility of each individual and the health – economic aspects. A significant number of people (up to 20%, and the likelihood increases with age) who fracture the hip, die within the next year, while almost a third is left with permanent disabilities.
Under the concept of hip fracture, there are different types of fractures of the wrist which can be attributed, but it usually refers to fractures of the upper thigh bone near the junction with the pelvic bone. Place of the fracture is also important because it can have different effects, that require a different conservative or surgical treatment and have a different prognosis. The most common type of fracture is intertrochanteric, which occurs on the line between great and lesser trochanter (bony nodes) and of the femur – if the patient is generally in good health – with good prognosis. Depending on the location, type and severity of the fracture symptoms can be different, but in any case what makes them different is the intensity of pain and limitation or the inability of moving the hurt side while in severe cases can be associated with internal injuries and shock.
Therapy of the fractured of hip, according to the clinical picture, can be conservative or surgical. The conservative methods include prolonged bed rest or the immobilization of the patient, with the use of drugs such as analgesics and corticosteroids, but this therapeutic approach is very inadequate and often reserved for the small number of patients with minor fractures. The most common surgical procedure is necessary when applying different techniques of reposition and fixation of bone fractures, and in some cases it is necessary to da a hip replacement. However, surgery in general, even on the hip joint, with its possible complications increase with the age of the patient. At a particularly high risk of death within the next few months after hip surgery are people older than 80.
Hip fractures are usually produced by the strong force on the the hip region and are usually a result of traffic accidents and falls. While these fractures as a result of traffic accidents equally affect all age groups, it is evident that a result of falls in most cases is more typical for older age. A healthy young person who falls from an upright position will not break a hip. So, if you leave out less common factors such as metabolic disorders, infections and bone tumors, the most common cause leading to hip fracture during the fall is osteoporosis. It represents a very serious and growing socio-economic problems, especially in societies with increasingly aged population. Hip fracture as a result of the fall is almost twice as common in women, since osteoporosis is also more common in females, and the frequency of fractures in both sexes is consistently growing year after year. Measures to regulate the behavior of traffic participants such as the recently enacted law on traffic, which increases the standard of safety at work and other measures, it would seek to reduce the incidence of hip fractures due to road traffic accidents, accidents at work, etc. However, the problem remains with bones “inclined” to fractures in people with osteoporosis. It is therefore essential that we speak about osteoporosis – a disease that does not hurt in the beginning and that the person does not feel until her spinal vertebra or hip fractures – because there are ways and means to prevent it or to significantly slow down the its flow. During the aging, bone density decreases, which is a natural process due to changes in the metabolism of hormones, vitamins and minerals, and it is called a senile osteopenia. If the bone loss is greater than expected for age and gender, pathological process known as osteoporosis is evolving. The most effective, non-invasive and safe way to check the condition of the bone tissue is a preview of a special device – osteodensitometry – so that the doctor would determine if it is osteopenia or osteoporosis. In the second case, the specific treatment is indicated or a therapy which will increase bone density and decrease the possibility of their fractures. What is particularly important is that with osteopenia and osteoporosis is usually a deficit of calcium and vitamin D, especially in postmenopausal women. Throughout life, there is a balance between bone formation and resorption, and this process is changing over the years at the expense of construction, among other things, because the blood does not have enough calcium, which would be embedded in the bone, and vitamin D, which enables this process.
Since bone fractures, especially hip, is a condition that can cause death or permanent storage consequences, which are often a consequence of osteoporosis, it can be concluded that the prevention of this disease is very important. On the other hand, calcium and vitamin D as a dietary supplement, along with other hygiene-dietetic measures (physical activity, nutrition, and the like.), represent a simple, easily available and effective preventive measure. Recommended for all high-risk groups, especially women after menopause, and the ordinary course examinations and consultations with a doctor to monitor the most reliable measure of bone density and prevent osteoporosis.