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Hip fracture

Medically reviewed by Drugs.com. Last updated on May 5, 2022.

Overview

A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age.

Risk increases because bones tend to weaken with age (osteoporosis). Multiple medications, poor vision and balance problems also make older people more likely to fall — one of the most common causes of hip fracture.

A hip fracture almost always requires surgical repair or replacement, followed by physical therapy. Taking steps to maintain bone density and avoid falls can help prevent a hip fracture.

Symptoms

Signs and symptoms of a hip fracture include:

Causes

A severe impact, such as a car crash, can cause hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting.

Risk factors

Many things can increase the risk of hip fractures.

Your age and sex

Bone density and muscle mass tend to decrease with age. Older people can also have problems with vision and balance, which can increase the risk of falling.

Hip fractures occur in women about three times more often than they do in men. Women lose bone density faster than men do, in part because the drop in estrogen levels that occurs with menopause accelerates bone loss. However, men also can develop dangerously low levels of bone density.

Medical conditions

The risk of hip fracture can be increased if you have:

Certain medications

Cortisone medications, such as prednisone, can weaken bones if taken long-term. Certain drugs or certain combinations of medications can cause dizziness, which can increase the risk of falling. The most common drugs associated with falls include sleep medications, antipsychotics and sedatives.

Nutritional problems

Lack of calcium and vitamin D in the diet of young people lowers peak bone mass and increases risk of fracture later in life. It's also important to get enough calcium and vitamin D in older age to try to maintain bone density. Being underweight also increases the risk of bone loss.

Lifestyle choices

Lack of regular weight-bearing exercise, such as walking, can result in weakened bones and muscles, making falls and fractures more likely.

Tobacco and alcohol both can interfere with the normal processes of bone building and maintenance, resulting in bone loss.

Complications

A hip fracture can reduce independence and sometimes shorten life. About half the people who have a hip fracture aren't able to regain the ability to live independently.

When hip fractures prevent movement for a long time, complications can include:

Prevention

Healthy lifestyle choices in early adulthood build a higher peak bone mass and reduce the risk of osteoporosis in later years. The same measures adopted at any age might lower the risk of falls and improve overall health.

To avoid falls and to maintain healthy bone:

Diagnosis

A health care provider can often diagnose a hip fracture based on symptoms and the abnormal position of the hip and leg. An X-ray usually will confirm the fracture and show where the fracture is.

If your X-ray doesn't show a fracture but you still have hip pain, your provider might order an MRI or bone scan to look for a hairline fracture.

Most hip fractures occur in one of two locations on the long bone that extends from the pelvis to your knee (femur):

Types of hip fractures

Most hip fractures occur in one of two locations — at the femoral neck or in the intertrochanteric region. The location of the fracture helps determine the best treatment options.

Treatment

Treatment for hip fracture usually involves a combination of prompt surgical repair, rehabilitation, and medication to manage pain and to prevent blood clots and infection.

Surgery

The type of surgery generally depends on where and how severe the fracture is, whether the broken bones aren't properly aligned (displaced), and your age and underlying health conditions. Options include:

Surgeons may recommend a full or partial hip replacement if the blood supply to the ball part of the hip joint was damaged during the fracture. That type of injury, which occurs most often in older people with femoral neck fractures, means the bone is less likely to heal properly.

Rehabilitation

Physical therapy will initially focus on range-of-motion and strengthening exercises. Depending on the type of surgery and whether there's help at home, going to an extended care facility might be necessary.

In extended care and at home, an occupational therapist teaches techniques for independence in daily life, such as using the toilet, bathing, dressing and cooking. An occupational therapist will determine if a walker or wheelchair might be needed to regain mobility and independence.

Repair options

A hip fracture can be repaired with the help of metal screws, plates and rods. In some cases, artificial replacements (prostheses) of parts of the hip joint may be necessary.

Preparing for your appointment

You may be referred to an orthopedic surgeon.

What to expect

Your health care provider might ask:

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