Key Points about Hip Fractures

  • A hip fracture is a break in the femur (thigh) bone, causing discomfort and pain when flexing or rotating the hip.
  • There are three different types of hip fractures depending on where on the upper femur the break occurs.
    • Intracapsular Fracture: Occurs at the neck and head of the femur (thigh bone) and generally within the soft tissue capsule of the hip joint.
    • Intertrochanteric Fracture: Occurs between the neck of the femur and the lesser trochanter (lower bony area of the hip).
    • Subtrochanteric Fracture: Occurs between the lesser trochanter and 2.5 inches below the lesser trochanter.
  • Hip fractures are typically caused by blunt force or falling. The most common symptom is severe pain in the groin area.

Overview

A hip fracture is a break in the upper part of the thigh bone (femur). Depending on the amount of force involved, the extent of the break can vary. Your doctor will determine the most appropriate surgical treatment for you that will be based upon the severity of the fracture as well as what bones and soft tissues were damaged surgery may be recommended.

A direct blow commonly causes many cases of hip fractures. You may also experience a hip fracture from falling. In some cases, medical conditions such as osteoarthritis can cause stress or weaken the bone and make it more likely to fracture.

The most common symptoms related to hip fractures are pain in the groin or outer upper thigh that is accompanied by discomfort when flexing or rotating the hip.

Hip fracture causes

Potential causes of a fractured hip include:

  • Falling
  • Blunt trauma to the hip
  • Osteoporosis
  • Obesity
  • Cancer

Hip fracture risk factors

Hip fractures risk factors do not cause hip fractures but may increase a person’s likelihood of having one. The risk factors associated with hip fractures include:

  • Osteoporosis is the leading cause of hip fractures
  • Age
  • Excessive alcohol and caffeine consumption
  • Low body weight
  • Tall stature
  • Vision problems
  • Dementia
  • Medications that may cause bone loss

Other risk factors include:

  • Gender: 70% of fractures occur in women.
  • Hereditary: If you have a family history of broken bones, you are at higher risk.
  • Arthritis: osteoarthritis and rheumatoid arthritis patients are more likely to sustain a fracture.
  • Lifestyle: Smoking, alcohol use, poor nutrition, lack of movement, and exercise puts you at higher risk.

Hip fracture prevention

Some causes of a hip fracture can be prevented. There are a variety of things you can do to lower your chances of experiencing a hip fracture, including:

  • Weight-bearing exercising: Walking, jogging, or hiking.
  • Exercise programs: Programs can help with strength and balance.
  • Medication: Can be prescribed medication to help with bone loss.

Hip fracture symptoms

  • Severe pain in the lower groin and hip area.
  • Unable to walk or put weight on your leg.

Typically, these symptoms occur after a fall, but bones can break without falling if you have osteoporosis.

Hip fracture complications

A hip fracture can lead to severe complications. Some complications, such as a blood clot that breaks off and travels to the lung or heart, can be fatal.

Potential other complications:

  • Infection after surgery
  • Weakening or wasting away of muscle tissue
  • Pneumonia
  • Improper alignment of the bones
  • Depression or mental deterioration from immobility
  • Bedsores from minimal movement in bed
  • Loss of blood to the hip area

It is imperative that you follow your doctor’s instructions to prevent complications.

Hip Fracture Diagnosis

Your doctor can diagnose a hip fracture with an X-ray exam. An X-ray can confirm if you have a fracture and where it is.

If a fracture isn't evident in the X-ray, your doctor may use an MRI or bone scan to look for hairline fractures.

During the physical exam, your doctor will review your full medical history to determine if you are at high risk for future fractures.

Hip fracture treatment

Some patients may be candidates for nonsurgical treatment for hip fracture. If you are too ill to undergo anesthesia or are unable to walk, your doctor will likely develop an alternative nonsurgical treatment plan for your case.

Other patients who have stable fractures may be candidates for nonsurgical treatment. In these cases, patients must be closely monitored to ensure the fracture does not change position.

In most cases, surgery is required to treat hip fractures. It is important to have surgery as soon as possible after the fracture occurs. Recovery is typically quicker, the sooner you have surgery.

The type of surgery you need will be based on the severity of your break and where it is located.

Surgical treatment options include:

  • Internal repair using screws (Hip pinning): If your bones can be lined up properly, hip pinning is an option. Metal screws are used to hold the bone together until the fracture heals.
  • Total hip replacement: The upper femur and socket in your pelvic bone are replaced with a prosthesis.
  • Partial hip replacement: a metal replacement for the head and neck of the femur.

After surgery, your doctor will likely recommend physical therapy. Physical therapy can help you regain strength and focus on the range-of-motion for your hip. If you have osteoporosis, medications may be prescribed to prevent additional fractures.

When should I seek care?

If you think you have suffered a hip fracture and are unable to walk or move, go to the emergency room right away. If your symptoms are less severe, call your doctor immediately and ask him or her what they recommend.

Next Steps

Follow your doctor's recommendations. If you have a fracture, it is essential to get treated right away. To resume your normal activity level as soon as possible, carefully follow the physical therapy plan.