A hip fracture is a break in the thigh bone just below the hip joint. The hip joint consists of a ball at the top of the thigh bone and a rounded socket in the pelvis. Most hip fractures occur 1-2 inches below the ball portion of the hip.
|Copyright © Nucleus Medical Media, Inc.
A hip fracture is caused by a trauma to the bone. Fractures in young people with healthy bones are cause by major trauma. Fractures in older adults or people with conditions that lead to weakened bones may be caused by minor trauma.
Factors that increase the risk of fracture in people with healthy bones include:
- Motor vehicle accidents and other types of major trauma
- Sporting activity that places excess stress on the hip—can lead to stress fractures (rare)
Women are more likey than men to fracture their hips especially after menopause. Other factors that increase the risk of hip fractures include:
- Previous hip fracture or history of falling
- Age: 65 years or older
- Family history of fractures later in life
- Small-boned, slender body—low body weight
Factors that can weaken bone and increase risk of fractures include:
Osteoporosis—a bone-thinning condition that weakens all bones
- Poor nutrition
- Deficient intake or absorption of calcium and vitamin D
- Physical inactivity
- Kidney disease
- Cortisone or other steroids
- Thyroid disorder
- Low testosterone in men
- Bone conditions such as osteomalacia—rare
- Bone tumors—rare
Factors that increase the risk of falls that can lead to fractures include:
A hip fracture may cause:
- Pain in the hip
- Difficulty or inability to stand, walk, or move the hip
Abnormal appearance of the broken leg:
- Looks shorter
- Turns outward
The doctor will ask about your symptoms and how the injury occurred. A physical exam will be done.
Images may be taken of your bones. This can be done with:
Surgery is needed for most hip fractures to make sure the hip heals properly. Surgery will also allow you to move about as you recover. However, surgery may not be appropriate for some people with small fractures or poor overall health. These fractures will be monitored as they heal with imaging tests. Traction may also be used to hold the leg in the appropriate place while the bone heals.
Rehabilitation will be needed as you heal to help you regain muscle strength and balance.
Surgery may help prevent complications such as:
- Misalignment of the bone—some fractures can make pieces of the bone move out of place, if it heals this way it can cause problems with movement
- Interruption of blood flow to the bone—some fractures may slow or block blood flow to the bone which can lead to severe damage
- Fractures that are initially stable may become unstable
Fractures that are not repaired in surgery may also require long periods of bed rest. This inactivity can cause other health complications such as blood clots, pneumonia, and bed sores.
The type of surgery will depend on what part of the hip bone was broken, how severe the fracture was and the overall health of your bone. Surgical options include:
- Insertion of surgical plates and screws to realign the bones and/or support the fractured area. The bone will be able to heal more securely.
- Hip replacement—damaged areas of bone are removed and metal devices are inserted in their place. This surgery is reserved for those with severe bone injury or disease. More common in older adults.
You will be encouraged to get up and moving shortly after surgery. The amount of weight you can place on your hip will depend on the type of fracture and surgery. Your doctor will recommend assistive devices such as wheelchair, cane, or walker for your recovery and rehabilitation. You may also need help for daily tasks once you return home. Some may also need to spend time in a rehabilitation facility during the early stages of recovery.
Exercises and physical therapy will also be recommended to help you return to your normal level of activity.
Major trauma is typically caused by accidents and hard to avoid.
Talk to your doctor if you have osteoporosis
or are at risk for osteoporosis. Medications, dietary changes, and weight bearing activities may help slow bone loss.
To reduce the risk of falls:
- Ask your doctor if any of your medications may contribute to bone loss or symptoms of lightheadedness, drowsiness, or confusion.
- Get your eyes checked regularly.
- Clean spills and slippery areas right away.
- Remove tripping hazards such as loose cords, rugs, and clutter.
- Use non-slip mats in the bathtub and shower.
- Install grab bars next to the toilet and in the shower or tub.
- Put in handrails on both sides of stairways.
- Walk only in well-lit rooms, stairs, and halls.
- Keep flashlights on hand in case of a power outage.
FamilyDoctor.org—American Academy of Family Physicians
OrthoInfo.org—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Hip fracture. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated April 24, 2013. Accessed September 17, 2013.
Hip fracture prevention.
American Academy of Orthopaedic Surgeons website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00309. Updated January 2013. Accessed September 17, 2013.
Ly, Thuan V and Swiontkowski, Marc F
Management of femoral neck fractures in young adults.
Indian J Orthop. 2008 Jan-Mar; 42(1): 3–12 Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2759588/.
11/6/2009 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Sennerby U, Melhus H, Gedeborg R, et al. Cardiovascular diseases and risk of hip fracture.
van Diepen S, Majumdar SR, Bakal JA, McAlister FA, Ezekowitz JA. Heart failure is a risk factor for orthopedic fracture: a population-based analysis of 16,294 patients.
1/4/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Lee JS, Buzková P, Fink HA, et al. Subclinical thyroid dysfunction and incident hip fracture in older adults.
Arch Intern Med.
4/24/2014 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Ward RJ, Weissman BN, et al. ACR Appropriateness Criteria for acute hip pain: suspected fracture. Available at: http://www.acr.org/~/media/ACR/Documents/AppCriteria/Diagnostic/AcuteHipPainSuspectedFracture.pdf. Published 2013. Accessed April 24, 2014.