Hip Fracture

A hip fracture is a break in the upper part of the thigh bone (femur). This is usually the result of an injury, commonly a fall.

What are the causes?

This condition may be caused by:

• A direct hit or injury (trauma) to the side of the hip, such as from a fall or a car accident.

What increases the risk?

You are more likely to develop this condition if:

• You have poor balance or an unsteady walking pattern (gait). Certain conditions contribute to poor balance, including Parkinson disease and dementia.
• You have thinning or weakening of your bones, such as from osteopenia or osteoporosis.
• You have cancer that spreads to the leg bones.
• You have certain conditions that can weaken your bones, such as thyroid disorders, intestine disorders, or a lack (deficiency) of certain nutrients.
• You smoke.
• You take certain medicines, such as steroids.
• You have a history of broken bones.

What are the signs or symptoms?

Symptoms of this condition include:

• Pain over the injured hip. This is commonly felt on the side of the hip or in the front groin area.
• Stiffness, bruising, and swelling over the hip.
• Pain with movement of the leg, especially lifting it up. Pain often gets better with rest.
• Difficulty or inability to stand, walk, or use the leg to support body weight (put weight on the leg).
• The leg rolling outward when lying down.
• The affected leg being shorter than the other leg.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• A physical exam.
• X-rays. These may be done:
  • To confirm the diagnosis.
  • To determine the type and location of the fracture.
  • To check for other injuries.
• MRI or CT scans. These may be done if the fracture is not visible on an X-ray.

How is this treated?

Treatment for this condition depends on the severity and location of your fracture. In most cases, surgery is necessary. Surgery may involve:

• Repairing the fracture with a screw, nail, or rod to hold the bone in place (open reduction and internal fixation, ORIF).
• Replacing the damaged parts of the femur with metal implants (hemiarthroplasty or arthroplasty).

If your fracture is less severe, or if you are not eligible for surgery, you may have non-surgical treatment. Non-surgical treatment may involve:

• Using crutches, a walker, or a wheelchair until your health care provider says that you can support (bear) weight on your hip.
• Medicines to help reduce pain and swelling.
• Having regular X-rays to monitor your fracture and make sure that it is healing.
• Physical therapy. You may need physical therapy after surgery, too.

Follow these instructions at home:

Activity

• Do not use your injured leg to support your body weight until your health care provider says that you can.
  • Follow standing and walking restrictions as told by your health care provider.
  • Use crutches, a walker, or a wheelchair as directed.
• Avoid any activities that cause pain or irritation in your hip. Ask your health care provider what activities are safe for you.
• Do not drive or use heavy machinery until your health care provider approves.
• If physical therapy was prescribed, do exercises as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If directed, put ice on the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay bone healing. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• To prevent falls at home:
  • Use a cane, walker, or wheelchair as directed.
  • Make sure your rooms and hallways are free of clutter, obstacles, and cords.
  • Install grab bars in your bedroom and bathrooms.
  • Always use handrails when going up and down stairs.
  • Use nightlights around the house.
• Exercise regularly. Ask what forms of exercise are safe for you, such as walking and strength and balance exercises.
• Visit an eye doctor regularly to have your eyesight checked. This can help prevent falls.
• Make sure you get enough calcium and vitamin D.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
• Limit alcohol use.
• If you have an underlying condition that caused your hip fracture, work with your health care provider to manage your condition.

Contact a health care provider if:

• Your pain gets worse or it does not get better with rest or medicine.
• You develop any of the following in your leg or foot:
  • Numbness.
  • Tingling.
  • A change in skin color (discoloration).
  • Skin feeling cold to the touch.

Get help right away if:

• Your pain suddenly gets worse.
• You cannot move your hip.

Summary

• A hip fracture is a break in the upper part of the thigh bone (femur).
• Treatment typically require surgical management to restore stability and function to the hip.
• Pain medicine and icing of the affected leg can help manage pain and swelling. Follow directions as told by your health care provider.