What is a hip fracture?
A hip fracture is a break in the thighbone (femur) of your hip joint.
Joints are areas where 2 or more bones meet. Your hip joint is a "ball and socket"
joint, where your thighbone meets your pelvic bone. The ball part of your hip joint
is the head of the thighbone. The socket is a cup-like structure in your pelvic bone.
This is called the acetabulum. Hip fracture is a serious injury and needs immediate
Most hip fractures happen to people older than age 60. The incidence of hip fractures
increases with age, doubling for each decade after age 50. Caucasians and Asians are
more likely to be affected than others. This is primarily because of a higher rate
of osteoporosis. Osteoporosis (loss of bone tissue) is a disease that weakens bones.
Women are more prone to osteoporosis than men; therefore, hip fracture is more common
among women. More than 1.5 million Americans have fractures each year because of osteoporosis.
Either a single break or multiple breaks can happen in a bone. A hip fracture is classified
by the specific area of the break and the type of break(s) in your bone.
The most common types of hip fractures are:
Femoral neck fracture. A femoral neck fracture happens 1 to 2 inches from your hip joint. This type of fracture
is common among older adults and can be related to osteoporosis. This type of fracture
may cause a complication, because the break usually cuts off the blood supply to the
head of the thighbone, which forms the hip joint.
Most hip fractures fall into these 2 categories in relatively equal numbers. Another
type of fracture, called a stress fracture of the hip, may be harder to diagnose.
This is a hairline crack in the thighbone that may not involve your whole bone. Overuse
and repetitive motion can cause a stress fracture. The symptoms of this injury may
mimic those of tendonitis or muscle strain.
What causes a hip fracture?
A fall is the most common reason for a hip fracture among the elderly. A few people
may have a hip fracture happen spontaneously. If you are younger, a hip fracture is
generally the result of a car accident, a fall from a great height, or severe trauma.
Hip fracture is more common in older people. This is because bones become thinner
and weaker from calcium loss as a person ages. This is generally due to osteoporosis.
Bones affected by osteoporosis are more likely to break if you fall. Most hip fractures
that older people get happen as a result of falling while walking on a level surface,
often at home.
If you are woman, you lose 30% to 50% of your bone density as you age. The loss of
bone speeds up dramatically after menopause, because you make less estrogen. Estrogen
contributes to maintaining bone density and strength.
Who is at risk for hip fracture?
You are at risk for a hip fracture if you have osteoporosis. Older age also puts you
at more risk. Other things that may raise your risk include:
Excessive alcohol consumption
Lack of physical activity
Low body weight
Poor nutrition including a diet low on calcium and vitamin D
Thinking problems such as dementia
Medicines that cause bone loss
Living in an assisted-care facility
Increased risk for falls, related to conditions such as weakness, disability, or unsteady
There may be other risks, depending on your specific health condition. Discuss any
concerns with your healthcare provider.
What are the symptoms of a hip fracture?
The following are the most common symptoms of a hip fracture:
Hip pain or pain that you can feel in your knee
Low back pain
Inability to stand or walk
Bruising and swelling
Foot turned out at an odd angle, making your leg look shorter
The symptoms of hip fracture may seem like other medical conditions. Always see your healthcare
provider for a diagnosis.
How is a hip fracture diagnosed?
In addition to a complete medical history and physical exam, diagnostic procedures
for hip fracture may include the following:
X-ray. Invisible electromagnetic energy beams produce images of internal tissues, bones,
and organs onto film.
MRI. A combination of large magnets, radiofrequencies, and a computer produce detailed
images of organs and structures within your body.
CT scan. This is an imaging test that uses X-rays and a computer to make detailed images of
the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans
are more detailed than standard X-rays.
How is a hip fracture treated?
A fracture of your hip is generally treated with surgery. Your surgeon may use metal
devices to strengthen and stabilize your joint. In some cases, he or she may do a
partial or total hip replacement. The type of surgical repair will depend on the type
of hip fracture. Your surgeon will determine the best procedure for you, based on
your situation. The goal of treatment is to provide relief from pain and enable you
to resume your normal activity level. Hip surgery usually requires an in-hospital
stay. While in the hospital, you start doing physical therapy exercises to regain
strength and range of motion in your hip. Physical therapy will continue at home or
on admission to a rehabilitation facility.
What are possible complications of hip fracture?
Serious complications can result from a hip fracture. Blood clots can happen in the
veins, usually in your legs. If a clot breaks off, it can travel to a blood vessel
in your lung. This blockage, called a pulmonary embolism, can be fatal.
Other complications can include:
Muscle atrophy (wasting of muscle tissue)
Nonunion or improper union of your bone
Mental deterioration after surgery in older patients
Bedsores from lying in the same position with minimal movement
With some fractures, blood can't circulate properly to the head of the thigh bone.
This results in a loss of blood supply to this area. This is called femoral vascular
necrosis, or avascular necrosis. This complication may happen, depending on the type
of fracture and the anatomy of your blood supply to the head of the thigh bone. This
is more common with femoral neck fractures.
Most people spend from 1 to 2 weeks in the hospital after a hip fracture. The recovery
period may be lengthy, and may include admission to a rehabilitation facility. If
you were previously able to live independently, you will generally need help from
home caregivers or family, or need the services of a long-term care facility. Hip
fractures can result in a loss of independence, reduced quality of life, and depression.
This is especially true for older people.
What can I do to prevent a hip fracture?
Preventive measures include taking enough calcium every day.
If you are a woman at menopause, you should consider having a bone density test. This
measures your bone mineral content and the thickness of your bone. This measurement
can indicate decreased bone mass. This is a condition in which your bones are more
brittle and more prone to break or fracture easily. A bone density test is used primarily
to diagnose osteoporosis and to determine fracture risk.
Women make less estrogen when menopause starts. Most people do not know they have
osteoporosis until they have a fracture.
Another way to help prevent hip fracture is to do regular weight-bearing exercise,
such as walking, jogging, or hiking. Exercise programs such as Tai Chi help promote
strength and balance.
Other preventive measures may include:
Taking medicines as prescribed by your healthcare provider to prevent bone loss
Eating a diet rich in vitamin D and calcium, including milk, cottage cheese, yogurt,
sardines, and broccoli
Not drinking too much alcohol
Keeping objects off the stairs and floors, such as electrical cords, to prevent falls
Using slip-resistant rugs next to the bathtub, and installing grab bars in the tub
Positioning night lights from the bedroom to the bathroom
Using rug pads or nonskid backing to keep rugs in place
Not using unsteady furniture or step ladders to stand on
Visiting an ophthalmologist every year to have vision checked annually and vision
Key points about hip fracture
Most hip fractures happen to people older than 60.
A fall is the most common reason for a hip fracture among elderly adults.
Hip fracture is more common among women.
Osteoporosis and advancing age are the major risk factors.
A fracture of the hip is generally treated with surgery.
Serious complications can result from a hip fracture.
Women at menopause should consider having a bone density test.
Regular weight-bearing exercise helps to prevent a hip fracture.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells
At the visit, write down the name of a new diagnosis, and any new medicines, treatments,
or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also
know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that
Know how you can contact your provider if you have questions.