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
A direct hip fracture is a disaster. 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.
Note the right leg is shorter and is rotated outward.
With an avulsion 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.
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.
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