Hip fracture is not destiny

Among the spine, wrist and hip fractures caused by osteoporosis, the most dangerous is the hip fracture. Every year, 1.6 million people worldwide experience a hip fracture. This number increases as the population ages. (Source: International Osteoporosis Foundation - Global statistics, 2022)

WHAT HAPPENS AFTER THE FRACTURE?

After a hip fracture, the process of hospitalization, surgery, and rehabilitation begins. However, the following data is daunting:

- 1 in 5 patients dies within the first year. - 50% cannot walk again.

- 25% become dependent on a nursing home or care home. (Source: Journal of Bone and Mineral Research, 2021)

Causes of falls at home

The most common factors causing falls at home:

- Slippery floors and bathroom tiles. - Unsecured carpets and rugs. - Lack of night light. - Low furniture, steps.

- Visual impairments and low lighting. (Source: National Institute on Aging - Fall prevention guide, 2023)

What happens after the surgery?

Hip fractures are usually treated with surgery. However, older patients are at higher risk of surgical complications:

- Pneumonia - Clot formation - Heart rhythm disorders - Bed sores Therefore, early mobilization, physical therapy and care support are essential. (Source:

American Geriatrics Society, 2020)

Hip fracture risk tests

1. One-legged standing test - How is it done? Arms at the sides, eyes open, one foot is lifted off the ground. - Risk criteria

If you cannot maintain your balance for less than 10 seconds, you are at high risk of falling. (Source: Journal of Geriatric Physical Therapy)

2. 4 meter walking test

- How is it done? A distance of 4 meters is measured, the person walks at a normal pace, and time is kept. - Risk criterion Walking speed below 0.8 m/s is associated with a high risk of falling.

- It is also linked to decreased overall life expectancy. (Source: National Institutes of Health (NIH)

3. Sit-stand chair test

- How is it done? It is measured how many times a person can sit down and stand up in 30 seconds without using their arms.

- Risk criterion below 10 in individuals over the age of 65 indicates low muscle strength and therefore a risk of fracture. (Source: CDC – STEADI Initiative for Fall Prevention)

4. Timed Up and Go (TUG) Test

- Common in clinical settingGet up from chair, walk 3 meters, turn back and sit down.- Risk criteria

If it exceeds 12 seconds, the risk of falling has increased. Source: American Geriatrics Society

Cost of surgery

The total average cost of hip fracture surgery + rehabilitation + physical therapy can reach 75,000 TL. (Source: Ministry of Health Treatment Reimbursement List, 2024)

Women or men?

Osteoporosis is more common in women, but hip fractures are more common in men. The reason is that osteoporosis is usually diagnosed late in men and the fracture occurs at an older age. (Source: Osteoporosis International, 2023)

Menopause and 10% loss in four years

For women, menopause is a threshold when bone destruction accelerates. When estrogen decreases, bone formation slows down. In the first 4 years after menopause, women lose about 10% of their bone mass. (Source: North American Menopause Society, 2020)

Will there be a second fracture after the fracture?

Yes. The risk of a second fracture within 2 years increases by 50% in people who have had a hip fracture. In other words, a fracture creates a domino effect not only in the bone but also in the risk chain. However, this event further impairs mobility, muscle strength and balance reflexes in older individuals.

This increases the risk of a second fracture. Approximately 10% of older adults who have a hip fracture will have a second fracture within 6 months. The spine, other hips and pelvis are most commonly affected. Those who experience a first fall have a greater than 30% chance of falling again within a year. Patients who remain partially independent after a first fracture often require long-term care after a second fracture. (Source: British Orthopaedic Association, 2022)

Tomorrow:

- Preventive lifestyle strategies - Type and frequency of exercise - Long-term fall prevention plan - Consistency of vitamin D and calcium intake