Hip Fracture (Broken Hip)

What is a hip fracture?

A hip fracture is the medical name for breaking the upper part of your thigh bone (femur) near your hip joint.

Your femur is the longest and strongest bone in your body, so it usually takes a serious fall, car accident or other trauma to break it. You’ll almost always need surgery to repair a hip fracture.

People sometimes joke about broken hips as shorthand for a friend getting older. This is usually just playful teasing, but it’s important to remember that broken hips are serious, potentially life-changing injuries.

Types of hip fractures

Your hip is a ball-and-socket joint. The ball-shaped top (the head) of your femur fits into a socket (the acetabulum) in your pelvis. A broken hip is a broad category that means any type of bone fracture that affects the upper part of your femur.

Healthcare providers classify broken hips based on where the femur breaks:

• Femoral head fractures: The femoral head is the rounded cap at the top (proximal) end of your femur. It’s very rare to break your femoral head.
• Femoral neck fractures (subcapital or intracapsular fractures): The femoral neck is the bridge between your femur’s rounded head and the long shaft that runs down through your thigh. It’s the most common place for hips to break.
• Intertrochanteric fractures: The greater and lesser trochanters are bumps of bone that stick out just around the femoral neck. Muscles and tendons attach to the trochanters. Intertrochanteric fractures happen when a hip fracture breaks the space between these bony bumps.

Providers may also give a hip fracture a name based on the fracture’s pattern (its shape or direction), including:

• Transverse fractures.
• Oblique fractures.
• Spiral fractures.
• Comminuted fractures.

What are hip fracture symptoms?

The most common hip fracture symptoms include:

• Severe hip pain.
• Not being able to move your hip or leg (limited mobility).
• A bump you can feel or see.
• Swelling.
• Bruising.
• Your hip looking noticeably different (deformity).

What causes hip fractures?

It usually takes severe trauma to break your hip. The most common causes of hip fractures include:

• Falls.
• Car accidents.
• Sports injuries.

What are the risk factors?

Anyone can experience sudden trauma and break a hip, but some people are more likely to, including:

• Adults older than 65.
• People with health conditions that weaken their bones (like osteoporosis or osteopenia).
• People assigned female at birth (AFAB).
• Athletes who play contact sports.

It usually takes a fall from a big height (like off a ladder or roof) to fracture your hip. But adults older than 65 or people with health conditions that weaken their bones are much more likely to break a hip after minor slips and falls at home or in their daily routines.

Any health condition that affects your balance, stability or ability to walk and move (your gait) can increase your risk of breaking a hip. Some conditions that can reduce your stability include:

• Parkinson’s disease.
• Vertigo.
• Gait abnormalities.
• Epilepsy and other conditions that cause seizures.

How do healthcare providers diagnose hip fractures?

A healthcare provider will diagnose a broken hip with a physical exam and imaging tests. Providers in the emergency room might diagnose the fracture in the ER if you experience a severe fall or other trauma.

Your provider will use at least one of the following types of imaging test to take pictures of your hip and the area around it:

• Hip X-ray.
• MRI (magnetic resonance imaging).
• CT scan (computed tomography scan).

What are hip fracture treatments?

Almost everyone with a hip fracture needs surgery. Which type of surgery you’ll need depends on the fracture’s severity and type, and if you have any other injuries or health conditions. The two most common surgeries for hip fractures include:

• Hip replacement (hip arthroplasty): Adults older than 65 who experience a hip fracture usually need a hip replacement. You may need a total or partial replacement.
• Open reduction and internal fixation (ORIF): Your surgeon will insert screws, pins or plates, or a metal rod into your femur to secure the pieces of your bone in place while they heal. Some people live with these fasteners in their bodies forever. Others need them removed once their hips heal.

Hip fracture surgery complications

Hip fracture surgery complications can include:

• Avascular necrosis: Avascular necrosis is bone death that happens when blood flow is cut off to a bone for too long.
• Nonunion: Your bone may not grow back together completely or at all.
• Malunion: This happens when a broken bone doesn’t line up correctly while it heals.
• Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.

How can you prevent hip fractures?

You may not always be able to prevent hip fractures, especially because sudden falls or other trauma you can’t plan for cause them. Follow these general safety tips to reduce your risk of falls and injuries:

• Make sure your home and workspace are free of clutter that could trip you or others.
• Talk to your provider about a bone density test if you’re older than 65 or if members of your biological family have osteoporosis.
• Follow an eating and physical activity plan that’ll help you maintain good bone health.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.

What is the recovery time for a fractured hip?

It usually takes at least a few months to recover from a broken hip. You may feel and notice improvements gradually over a year after treatment. How long it takes you to recover will depend on a few factors, including:

• Which type of surgery you needed.
• Which other injuries you may have.
• Your age.
• Your overall health.
• What caused the fracture.

Your surgeon will tell you what to expect and give you a recovery timeline that matches your unique needs.

You’ll start physical therapy (PT) soon after surgery. You may need PT for several months to help you regain your ability to move and walk. A physical therapist will give you exercises and stretches to strengthen the muscles around your hip.

You may need a walker, cane or crutches while you recover from surgery. Some people need them for longer. Ask your surgeon or physical therapist how long you should use mobility aids.

Why is a hip fracture so dangerous?

Hip fractures are emergencies. In addition to the damage to your femur and hip joint, hip fractures often happen alongside other major injuries. That’s especially true if you experience a severe fall or car accident.

Any injury severe enough to break your femur may also damage your femoral artery. This can cause a fatal amount of blood loss if a healthcare provider doesn’t treat it immediately. A broken hip can also increase your risk of blood clots.

The kinds of trauma that cause hip fractures can be especially dangerous for adults older than 65. The older you are, the longer it takes your body to heal any injury, and that’s especially true when you have a major one like a hip fracture. The surgery to treat a hip fracture (and the recovery from it) can be harder for an older adult, too.

Studies have found that adults older than 65 who’ve experienced a hip fracture are more likely to reduce or stop physical activity like walking and to cut back on social activities and hobbies, even after they recover. This isolation can impact your overall health. Talk to your provider about how to stay active after you’ve had a hip fracture. They can suggest safe ways to stay engaged with your loved ones and favorite activities.

When should I go to the emergency room?

All hip fractures are medical emergencies. Call 911 (or your local emergency services number) if you think you have a broken hip. Call emergency services if you experience a fall, car accident or another trauma and experience any of the following symptoms:

• You can’t move your hip or leg.
• You’re in intense pain.
• Your hip or leg is noticeably different-looking or out of its usual place.
• You can see bone through your skin.
• Your hip is very swollen.
• You notice severe bruising that develops at the same time as any of these other symptoms.

Which questions should I ask my doctor?

Questions you may want to ask your provider include:

• Which type of hip fracture do I have?
• Which type of surgery will I need?
• How soon will I need to start physical therapy?
• How long will it take me to recover?

Can you still walk with a broken hip?

You can’t stand, walk or put weight on a broken hip. Putting pressure on your hip can make the fracture worse and cause other complications and injuries.

Your surgeon or healthcare provider will show you how to safely stand, walk and move after surgery and while you recover.

Can you move a person with a broken hip?

Call 911 (or your local emergency services number) if you think someone has a broken hip. Only trained healthcare professionals should move, lift or transport someone who has a broken hip. Try to keep the person’s hip stable and supported. Don’t put any pressure on their leg or try to get them to stand or walk.

Ask the dispatcher or operator who answers your emergency call for tips on keeping the person safe and stable while you wait for help to arrive.