Hip Fracture

Hip fractures are a serious health problem common among elderly men and women who fall. In 2003, the US Centers for Disease Control and Prevention reported that there were approximately 345,000 hospitalizations for hip fractures. Only one in four patients typically recovers completely.

A hip fracture is a break near the top of your thighbone (femur) where it angles into your hip socket. When you break your hip, it usually hurts too much to stand and your leg may turn outward or shorten. Immediate medical attention should be sought. In most instances, hospitalization and surgery are required.

Diagnosis

Your doctor will obtain X-rays of both of your hips to determine exactly where the bone broke and how far out of place the pieces have moved. If the fracture does not show up on X-rays, MRI (magnetic resonance imaging) will likely be needed. Most hip fractures are one of two types:

  • Femoral Neck Fractures: 1 to 2 inches from the joint.
  • Intertrochanteric Fractures: 3 to 4 inches from the joint.

 

Surgery and Early Mobilization

Modern treatment for a hip fracture aims to get you back on your feet again as soon as possible while your broken bone heals. (Treatment may vary for certain elderly people who were already bedridden, have other complicated medical conditions, and are not in much pain.) Your doctor will reposition the fracture and hold it in place with an internal device.

  • For femoral neck fractures, pins (surgical screws) are used if you are younger and more active, or if your broken bone has not moved much out of place. If you are older and less active, you may need a high-strength metal device that fits into your hip socket, replacing the head of your femur (hemiarthroplasty).
  • For intertrochanteric fractures, a metallic device (compression screw and side plate) holds the broken bone in place while it lets the head of your femur move normally in your hip socket.

Your doctor will tell you when you should start standing and walking again after surgery. You will probably need crutches, a walker, or other help. You may need to do physical therapy or rehabilitation exercises to get back to your normal level of activity.