Covers causes of hip fractures. Includes list of things that increase risk. Describes symptoms and how hip fractures are diagnosed. Covers treatment choices. Offers prevention tips, including ways to slow osteoporosis.
What is a hip fracture?
A hip fracture is more
than a broken bone. If you are older, breaking your hip can mean a major change
in your life. You will probably need surgery, and it can take as long as a year
to recover. But activity and
physical therapy can help you get your strength and
people break their hip near the upper part of the
thighbone (femur). It usually happens near where the thighbone fits into the hip
What causes hip fractures?
Most hip fractures happen to people who are 65 or older, and they are usually caused by falls.
As you get older, your bones naturally lose some
strength and are more likely to break, even from a minor fall. Children and
young adults are more likely to break a hip because of a bike or car accident
or a sports injury.
Other things that increase your risk of
breaking your hip include:
history—being thin or tall or having family members who had fractures later in
Not getting enough calcium and
vitamin D, which you need for strong bones.
active. Weight-bearing exercise, such as walking, helps keep bones
Medical conditions that cause
dizziness or problems with balance, or conditions such as arthritis that can
interfere with steady and safe movement.
medicines, such as long-term steroid medicines used to treat asthma or COPD.
What are the symptoms?
If your hip is broken, you will most likely:
Have severe pain in your hip
or lower groin area.
Not be able to walk or put any weight on
These symptoms are most common after a fall. But
if you have very thin bones from osteoporosis or another problem, you could
break your hip without falling.
In rare cases, people have only thigh or knee
pain. They may be able to walk.
How is a hip fracture diagnosed?
X-rays to diagnose a broken hip. You may need another test if your doctor thinks
that you have a fracture but can't see it on an X-ray. You might have a test such as:
An MRI, which gives better images of bones and soft tissues.
A CT scan, another way of getting more detailed images.
A bone scan, which involves injecting a dye, then taking images. It can show hairline fractures, where the bone is cracked but the pieces are still in place.
How is it treated?
You will most likely need surgery
to fix your hip. Surgery usually works well, but your hip will probably take a long time to get better.
Surgery is done as soon as possible after a hip fracture is diagnosed, often within 24 hours. Having surgery right away may help shorten your stay in the hospital and reduce pain and complications. Sometimes surgery is delayed for 1 to 2 days so other medical problems can be treated first. This may make surgery less risky.
The type of surgery you have
will depend on where the break is and how bad it is.
Hip repair surgery is called internal fixation or "hip pinning." The doctor uses metal screws, rods, or plates to hold the bone together while it heals. This surgery is usually chosen if the bones can be lined up properly.
Hip replacement surgery involves replacing part or all of the joint with artificial parts. In a partial hip replacement, the doctor replaces the broken upper part of the thighbone. In a total hip replacement, both the hip socket and the top of the thigh bone are replaced. Total hip replacement is often done when the fractured bones can't be properly lined up.
After surgery, your doctor will want
you to start moving as soon as you can. This will help prevent
problems such as pneumonia, blood clots, and bed sores. These things may happen
because you have to stay in bed so long. You may also need to take a blood-thinning medicine to reduce the risk of blood clots.
After your surgery, it will be hard to do things like cooking and getting dressed by yourself. So for a while you may need to be in a nursing
home or rehabilitation (rehab) center.
Your doctor will encourage you to take part in a rehab program that includes physical therapy and occupational therapy. This will teach you:
Exercises to help you regain your strength and ability to move around.
New ways to do simple daily activities.
Safe ways to stay active.
Taking part in a rehab program is very important because it will speed up your recovery and help you to get back to your normal activities sooner.
After a hip fracture, some people aren't ever able to get
around as well as they could before. They may need to use a walker or cane. They may need help with daily activities such as dressing and bathing. And many can no longer live on their own. Work hard to get your strength and mobility back so you can be as independent as possible.
How can you prevent a hip fracture?
There are many
things you can do to prevent a hip fracture. One of the most important is to
osteoporosis. Bone thinning can happen to men or women.
But it is more common in women.
To keep your bones strong:
Get plenty of calcium and vitamin D. Dairy foods like milk, cheese, and yogurt have lots of calcium. It's also in some vegetables like broccoli and kale. Vitamin D is in foods such as salmon, tuna, and fortified milk and cereals. If you want to take
supplements, ask your doctor how much you need.
Limit alcohol to no more than 1 drink a day for women and no more than 2 drinks a day for men.
exercise that puts pressure on bones and muscles. Walking is a good choice.
If your doctor prescribes medicine to slow osteoporosis, take it as directed.
You also need to be extra careful to prevent falls. Here are a few ways to make your home safer:
Keep walkways clear of electrical cords and clutter.
Be sure you have good lighting where you are
Put grab bars and non-slip mats in showers and tubs.
It can also help to:
Get your eyes checked on a regular basis.
Exercise to help keep your strength and balance.
Take medicines as directed. And from time to time, ask your primary care doctor to review your
medicines. Some medicines, such as sleeping pills or pain relievers, can increase
your risk of falling.
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The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
National Institute of Arthritis and Musculoskeletal and
Skin Diseases (NIAMS), National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
1-877-22-NIAMS (1-877-226-4267) toll-free
The National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS) is a governmental institute that serves the public
and health professionals by providing information, locating other information
sources, and participating in a national federal database of health
information. NIAMS supports research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases and supports the training of
scientists to carry out this research.
The NIAMS website provides
health information referrals to the NIAMS Clearinghouse, which has information
packages about diseases.
American Academy of Orthopaedic Surgeons and American
Academy of Pediatrics (2010). Fracture of the proximal femur. In LY Griffin,
ed., Essentials of Musculoskeletal Care, 4th ed., pp. 563–567. Rosemont, IL: American Academy of Orthopaedic Surgeons.
American Academy of Orthopedic Surgeons (2007).
Minimally Invasive Hip Replacement. Available online:
Gillespie LD, et al. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews (11).
Mercier LR (2008). Fractures of the hip section of The hip.
In Practical Orthopedics, 6th ed., pp. 207–211. St. Louis: Mosby Elsevier.
Oliver D, et al. (2010). Hip fracture, search date
April 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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