Hip Fracture

What is a hip fracture?
A hip fracture is a break at the upper end of your upper leg bone. This bone is called the femur, or thighbone. The fracture happens where the femur meets the pelvic bone.

Hip fractures are a serious injury. Most occur in women after menopause. Nine out of ten hip fractures occur in older adults.

How does it occur?
Hip fractures usually result from a fall. You are more likely to break your hip if you have osteoporosis. Osteoporosis is a thinning and weakening of the bones that can happen as you get older. Weak bones break more easily. Other diseases, such as cancer and kidney disease, may also weaken the bones and make it easier for them to break.

What are the symptoms?

Symptoms of a broken hip may include:

severe pain in the hip
not being able to put any weight on the injured leg
stiffness, bruising, and swelling in the hip
a leg that has gotten shorter or turns inward or outward
Any time an older adult falls and is unable to get up or stand on both legs, a hip fracture should be suspected. If you fall and cannot get back up, someone should call 911 or an emergency medical service right away. No one should try to move you until medical help arrives.

How is it diagnosed?

Your healthcare provider will review your medical history and examine your hip. Often the fracture is obvious from the abnormal position of the hip and leg.
An X-ray may show the fracture. (It will also show osteoporosis if you have it.) Sometimes an MRI scan is needed to see a fracture that does not show up on X-ray.

How is it treated?
Treatment without surgery
In some cases the hip may not be treated with surgery. For example, if the ends of the broken bone are impacted (pushed together firmly) by the fall, the bone can heal naturally. In this case, your healthcare provider may prescribe painkillers, bed rest, and physical therapy for a few weeks to allow healing. A broken hip may also be allowed to heal without surgery if you were previously not able to walk because of other medical problems.

Treatment with surgery
Most often after a hip fracture, the ends of the bone are separated and out of line. When this happens, surgery is needed to either repair the bone or replace the hip joint. The choice of surgical treatment depends on where the break is and any other medical conditions you may have. Usually the surgery is done no later than 2 days after the break. Sometimes you may have to wait longer than 2 days if you have other medical problems.

One type of treatment is pinning or screwing the broken pieces back together. This can be done with a metal plate put alongside the bone with screws into the bone (called plate and screws). Another treatment is sliding a metal rod through the center of the bones so that they come back together (called pinning). Pinning is the most common way to repair a hip fracture.

The other major treatment is having a total hip replacement. This treats hip socket arthritis and the hip fracture at the same time.

Your surgeon should discuss your treatment choices with you, your family members, or whomever you have appointed to help you with healthcare decisions.

How can I take care of myself?

Follow the treatment plan prescribed by your healthcare provider and physical therapist.
Use a cane or walker if you have been advised to do so.
If medicine to help prevent blood clots has been prescribed for you, be sure to follow your healthcare provider’s instructions for taking this medicine.
Follow your healthcare provider's recommendations for controlling osteoporosis.
How can I help prevent a hip fracture?

You can help prevent hip fractures by making your home safer, strengthening your bones, and exercising to get stronger. Talk to your healthcare provider about ways you can make your home safe, have stronger bones, and prevent falls. Ask about the types of exercise that might be best for you.

Also talk to your healthcare provider about the medicines you are taking. Some medicines, or changes in your medicines, can increase the risk of falling.

Try to have and keep a healthy weight. If you smoke, quit.

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