What is a hip fracture?
The hip is a ball-and-socket joint, meaning that the head of one bone fits into an opening in another. In the hip’s case, the head is on the end of the femur, or thigh bone, and the opening is in the pelvis.
Despite all these moving parts, the definition of a hip fracture—fracture is another term for a broken bone—is narrow: it is a break in the upper third of the femur. Damage to the socket or to another part of the pelvis is not considered a hip fracture.
Hip fractures are usually the result of high-energy trauma events like car accidents, or low-energy events such as falls. However, people at higher risk for hip fractures, such as older adults with osteoporosis, can fracture their hip doing mundane activities like walking. More than 270,000 hip fractures occur every year in the U.S.
Risk Factors
A person is more likely to fracture the hip if he or she:
- Is over the age of 65
- Is female
- Has a chronic condition such as osteoporosis, overactive thyroid or certain intestinal disorders that prevent the body from efficiently absorbing nutrients
- Is deficient in calcium or vitamin D
- Is physically inactive
Symptoms and Diagnosis
Symptoms of a hip fracture include:
- Bruising or swelling on the injured side
- Inability to move or put weight on the injured side
- Pain in the thigh or groin
- The injured leg appears shorter than the uninjured leg
A doctor can often diagnose a hip fracture based on these symptoms. An X-ray will usually confirm the diagnosis, but if the X-ray is inconclusive and the doctor still suspects a hip fracture, a magnetic resonance imaging (MRI) scan may be necessary.
Treatment
A hip fracture usually needs surgery, and proper aftercare is essential. Surgery is used to either repair or replace the hip. To repair the hip, surgeons will use pins, screws or plates to reconnect the fractured area and allow it to heal in one piece. If the hip cannot be repaired, partial or total hip replacement may instead be necessary.
It is critically important to get up and moving as soon as possible after hip surgery. Medical professionals will have the patient moving the same day of the surgery, if possible, and may recommend a physical therapy regimen. For older adults with hip fractures, bed rest can be dangerous. Prolonged bed rest can lead to complications such as:
- Bed sores
- Blood clots, which can lead to pulmonary embolisms
- Confusion
- Muscle loss and decrease in physical fitness, which is called deconditioning
- Pneumonia
- Sepsis
Complications
Not only are hip fractures painful and debilitating, the complications they can cause—such as sepsis and blood clots—may cause the death of older patients.
One 2010 study looked at data for more than 750 University of Rochester Medical Center patients over age 60 who had hip fractures. The study found that more than one in five died within a year. Other estimates put the one-year mortality rate between 11.5 percent and 39.5 percent. However, proper care can greatly increase the chances of survival, as well as quality of life.
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