Fractured Hip
Scenario:
Hip fractures are unusual in mountain biking. There are two types: (1) direct fracture, in
which the biker falls hard directly onto the hip. The upper femur is shattered. The victim
isn't able to stand up. (2) avulsion fracture, where a sudden stress on the hip causes a
tendon to pull a chunk of bone off. The victim can usually sit up and bear a little
weight.
A complete hip fracture is usually immobilizing, and it's obvious that's something is very wrong. As you look at the person's feet, the injured leg is usually around an inch shorter (compare the underside of the heels with the ankles together) and is turned outward compared to the uninjured side. The hip area will be tender and the person won't be able to walk.
With an avulsion fracture (chip fracture), there will be no outward signs of injury. It will hurt to move the hip, but the victim usually will be able to move the hip around. And while weight-bearing may be painful, the leg can usually support the victim once he's assisted into a standing position.
Immediate care:
A biker with an avulsion fracture may be able to walk a short distance back down the trail
with assistance. But the biker with a direct fracture will have to go out on a stretcher.
You'll usually have to call an ambulance for transportation to the emergency room. Don't
give the patient anything to eat or drink (an operation is usually necessary to fix the
broken hip). Don't move the patient unless absolutely necessary -- for example, if they're
out in the road. If it's necessary to move, use three people: two to carry the patient and
a third to support the leg. All suspected hip fractures should be seen by the physician.
