Hip Cultry: Major Public Health Problems

Katz, J. N., Wright, E. A., Polaris, J. J., Harris, M. B., & Losina, E. (2014, May 22). Prevalence and risk factors for periprosthetic fracture in older recipients of total hip replacement: a cohort study. BMC Musculoskeletal Disorders, 15(1), 1-9. http://dx.doi.org/10.1186/1471-2474-15-168Lewis, S. L., Dirksen, S. R., Heitkemper, M. M., Bucher, L., & Camera, I. M. (2011). Medical-surgical nursing: Assessment and management of clinical problems (8th ed.). St. Louis, MO: else

Mrs. Pink, aged 75 was admitted to the orthopaedic ward after suffering a fall at home, resulting in an intracapsular fracture of the hip at the femoral neck. Mrs. Pink has a history of cancer and cardiac diseases and has severe rheumatoid arthritis. Due to ageing patients putting a great deal of strain on the health care system, the incidences of hip fractures in the elderly are a major concern and requires careful consideration regarding treatment. Known as a major cause of disability in the elderly, hip fractures and their subsequent need for surgery result in chronic pain and an altered quality of life (Strike, Sieber, Gottschalk & Mears, 2013). Although important to improve a patient’s quality of life and physical independence, pain related to a total hip replacement (THR), also known as hip arthroplasty (HA) can lead to delays in ambulation, longer hospital stays, poor functional outcomes and quality of life. The purpose of this essay is to identify the rationale behind nursing interventions provided to post-operative THR patients as well as the pathology of a femoral neck hip fracture and their procedure for assessment and diagnosis.

Osteoporosis, meaning porous bone from the Greek language, is bone disease that gradually and steadily wears down bone tissue and its living cells. This wearing down will eventually cause the cells of bone tissue to degrade and die, leaving their “scaffolding” to be the only things only bone together. Without living cells to take up a home in this scaffolding, minor injuries such as falls, bumping into objects, and pressure that would normally be completely and would not pose any threat to bone tissue suddenly becomes a real hazard that can easily pose a threat to one’s well-being. Osteoporosis affects a person skeletal system.

As generally stated in the introduction, osteoporosis is a skeletal disorder that involves the strength and integrity of one’s bones. The WHO defines osteoporosis as, “a systemic skeletal disorder characterized by low-bone mass, deterioration of bone tissue, increased bone fragility, and its susceptibly to recurrent fractures.” 2 The most important factor to take into account when addressing osteoporosis is the mass of bone, also referred to as, bone mineral density (BMD). As bone mass begins to decline, typically in the older population, specifically postmenopausal women, individuals are at an increased risk for fractures.3 As a result of this serious condition, many people are affected by morbidity, mortality, and economic difficulty.1

Osteoporosis is the most common disease of the bone and the incidence of this condition is rising. Osteoporosis is estimated to effect 3 million people in the UK. A decreasing bone density in patient, especially in those above the age of 50, leads to bones becoming weak and therefore, there is an increased likelihood of fragility fractures. This condition is preventable and treatable however, it is often left undiagnosed and therefore, has major cost implications on the NHS. (National Osteoporosis Society, 2013a)

Hip fractures are one of the most common causes of extended hospital stay among the

Patients that experience hip fractures will die within a year. Many of these fractures are due to immobility according to assessment and Management of Clinical Problems (1788). Many falls occur in the older adult population and usually age over 60. Hip fractures not only happen with falls but also can come from blunt trauma to the hip, car accident, disease like osteoporosis and obesity can all be a major concern to hip fractures. The video talks about the common hip joint site are dislocation. Hip fracture may involve both vascular and bony damage to the body. Hip fractures are determined by atomic location of the fracture. These common fractures occur at the head of the femur, neck and greater trochanter. Over my twenty years of health care experience I have witness patients going through some difficult physical therapy. Many patients do not bounce back and many give up because the rehab is so

Many of the injuries suffered by older adults are serious and can lead to a significant impact on quality of life (CDC, 2012). For example, 45% of the fatal falls in 2000 involved a traumatic brain injury. Falling is also the primary cause of hip fractures (95%) and in 2009 afflicted 271,000 Americans. Three fourths of these hip fractures were suffered by women. Of those who do fall, including those who sustain no serious injuries, their vitality can suffer due to self-imposed physical restrictions. Muscles can atrophy and mental health can suffer due to a lack of social activities.

Nearly 10 % of falls are followed by serious injuries including fractures, head injury and injuries to the soft tissues. About 2% of falls result in hip fracture, which is among the leading cause of long-term disability and admission to nursing homes. Interestingly more than 90% of hip fractures, which are one of the most expensive surgical diseases to manage, are caused by

Osteoporosis is an age related disorder, more common in females compared to males. Osteoporosis is defined as a “skeletal disorder characterized by compromised bone strength predisposing to increased risk of fractures (Manolagaas, 2014). Osteoporosis is defined as “a disease characterized by low bone mass and deterioration of bone tissue (What is osteoporosis?2014). Osteoporosis is sometimes also referred as “silent thief” as the bone loss occurs very slowly and silently without any symptoms (Osteoporosis facts & statistics.2014). The most common site for fracture due to osteoporosis is hip followed by humerus (Woltman & den Hoed, 2010) . Osteoporosis can occur at any age, although it is a disorder common in females (especially post-menopausal females). Everyone is prone to osteoporosis (Osteoporosis facts & statistics.2014). According to Osteoporosis Canada, 1 in 3 Canadian females and 1 in 5 Canadian males may suffer fractures due to osteoporosis during their lifetime (Osteoporosis facts & statistics.2014). Canadian health care system spends 1.2 billion dollars for the acute hospitalization caused by osteoporosis and in 2010 the health care system spent 3.9 billion dollars for the total treatment of osteoporosis (Osteoporosis facts & statistics.2014). Osteoporosis can be screened and diagnosed by various methods; however the dual energy x ray absorptiometry (DXA) is commonly used. If the T-score values are less than -1 and greater than -2.5SD it is termed as osteopenia,

It is estimated that 1 in 3 adults over 65 years of age will fall each year (Stanford Health Care, 2016). By the time seniors reach 80 years, the risk of falling is 1 in 2 persons (Stanford Health Care, 2016). Broken bones mean more medicine, doctors’ visits, and surgeries, increasing healthcare costs to both individuals and the medical system (Jang, M. S., Lee, Y. S., & Kim, J. T. (2014). In 2013, the cost for treating fall-related injuries was more than $34 billion in the U.S. (NCSL, 20116). That money pays for the 2.5 million emergency room visits, for 700,000 hospitalizations, and toward the 25,000 deaths per year as a result of falls (NCSL, 20116).

Slipped capital femoral epiphysis, is a disease that slithers upon you like a snake. The pain begins in your lower leg, usually in the knee or ankle. However, that is not where the pain is truly located, the pain is located at the hip. The pain is caused by the displacement of the proximal femoral epiphysis from the metaphysis. A study of the disease in Germany, “with 411 overweight children in the study, 196 of them being males, the investigation showed 18.2% experienced reduced range of motion for hip flexing” (Wabitsch et al 2-3). The results from the German study showed that “eleven out of 54, showed signs of an abnormal head-neck ratio, this is a sign of prior silent slipped capital femoral epiphysis”

Aims: To evaluate in patients with a hip fracture the association between serum P1NP concentration (on admission) and clinical characteristics as well as short-term outcomes.

Osteoporosis-related fractures are more common than the rates of heart attack, stroke, and breast cancer combined

Bone disease is a silent disorder that may lead to pain and deformity. (NCBI, paragraph 1). NCBI resources mention that1.5 million osteoporotic fractures in the U.S leads to more than half a million of hospitalizations, about 800,000 emergency room encounters, about more than 2,600,000 physician office visits, and about 180,000 individuals are placed into nursing homes. (NCBI, paragraph 2), Caring for fractures from bone disease is expensive, ranging from $12 to $18 billion per year in 2002 and will increase over the years causing individuals and their families a devastating impact. (NCBI paragraph3). Some die from bone disease, many spirals downward in their physical and mental health that result in death, especially during the first year after the fracture. (NCBI, paragraph 4). People who suffer from fractures experience severe pain, height loss, lose the ability to dress themselves, stand up, and walk causing them to be at risk of pressure sores pneumonia, and urinary tract infections. (NCBI, paragraph 5)