Elderly people are obviously more susceptible to broken bones, why is it specifically a broken hip bone that is such a death knell?
In: Biology
A fractured hip means possible surgery, as well as prolonged time where you are unable to ambulate or are bed bound. The surgery and potential for infection are one danger, but losing your ability to ambulate is very bad as it can be hard to get back to where you were, and can lead to things like pressure sores, increased risk of pneumonia, blood clots, etc. The older you are the longer the process takes to recover, the less reserves you have, and the higher the risks for complication.
Hips don’t break easily. To break a hip as a young person, you probably need major trauma, like a car crash.
So, by the time you break a hip from a fall:
* All your other weaker bones are also trash
* Your reflexes are so slow that you can’t catch yourself during a fall
* Your body is full decay mode
* The only form of exercise that your cardiovascular system can handle is slow walking
Since you could barely walk safely before, and since hip breakages are already require long-term recovery, your odds of recovery are low.
The other answers cover a lot, what they are missing is fear. The trauma that is caused by a broken hip often limits the mobility of the patient, even when they could physically continue the activities. They will be more hesitant to do many of the activities they were before, this often leads to even simple things like climbing a few stairs. They will make excuses not to, although rational sounding at first, if watched they progress to anything to avoid activities that could lead to falling again. As the fear overshadows their lives, they will stay home more, stay in bed or sitting more. This will lead to continuing decline in muscle mass and deconditioning. It’s a cyclical system where the deconditioning makes it harder to do as much as they could a week ago so they avoid even more, increasing their deconditioning.
The muscles are not the only victims here, the heart and lungs become weaker with less use, skin becomes more prone to pressure sores. Movement promotes bowel motility. Bones become even weaker.
Ultimately, it becomes a downward spiral that can end in death if it is not addressed and monitored closely.
Orthopedics isn’t quite my specialty but I might be able to weigh in with my familiarity of the older population. I’m typing this up from my phone so I hope formatting is okay. Some of the other posters covered some very good points!
Semi fun-fact. Most hip fractures occur before the fall! Or rather they fell because their hip fractured and not the other way. Bones like muscle respond to exercise and stress by growing and becoming stronger. It also means that a very sedentary lifestyle means bone and muscle more or less wilts away. A sedentary lifestyle is bad for bone before, even worse after when you can’t move.
Another fun-fact. A good part of your lower extremity circulation is dependent on movement. That’s why its recommended to stretch your legs dueing periods of long sitting. Being unable to move puts you at elevated risk for things like blood clots.
Lastly and an unfortunate part of aging is the comorbidities (simultaneous diseases occurring at the same time) that arise. So maybe she has diabetes (long-time diabetes does a number to the body), high cholesterol, and poor circulation and to throw on the fracture just makes things incredibly difficult. Then different things start to come into question. Can this person even tolerate the surgery and the ADDED trauma he/she will have to go through for the procedure? Can this person tolerate the stages of recovery? What’s the quality of life look like for this patient after?
I thought-vomited so if anything is confusing or if there’s anything I’d be able to better explain, let me know!
I think it is definetely lack of movement that gets them. My dad was 78, and broke his hip. Surgery went well as he had a good, thick femur. He died 25 days later. It definetely makes me want to get as healthy and strong as I can now while it is easier. After watching my parents age, getting old isn’t for the weak.
The recovery from a broken pelvis involves being bedridden for months. That alone is very stressful on the body, you lose almost all of your muscle mass and the process of regaining your function is very stressful to your system. It is even harder for old people to recover from injuries and build muscle, so a broken hip can be too much damage for them to come back from
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