Hip Fracture

What is a hip fracture?

What we often call a hip fracture is actually a fracture of the neck of the femur (thighbone). The fracture occurs at the upper end of the femur where it meets the pelvic bone. It is a common fracture in people with osteoporosis. Osteoporosis is a condition in which bones become thin after middle age.

Most hip fractures occur in women after menopause. About 15% of all women have a hip fracture during their lifetimes.

How does it occur?

Hip fractures usually result from a fall. Because osteoporosis weakens the bones and makes them much more likely to break, hip fractures occur more often as men and women get older. One in four women have osteoporosis by the age of 60. By the age of 75, half of all men and women have it. In addition to osteoporosis, cancer, kidney disease, and some other diseases may make the bones weaker and more prone to breaking.

What are the symptoms?

• You have severe pain in your hip.
• You cannot bear to put any weight on your leg.
• You have stiffness, bruising, and swelling in your hip.
• Your leg is shortened or turns either inward or outward.

Any time an elderly person falls, and is unable to get up or stand on both legs, a hip fracture should be suspected. Do not try to move the person. Make him or her as comfortable as possible, and call 911 or an emergency medical service immediately.

How is it diagnosed?

Your health care provider will review your medical history and examine your hip. Often the fracture is obvious from the abnormal position of the hip and leg.

An x-ray usually shows the fracture. It will also show osteoporosis if you have it.

How is it treated?

If the ends of the broken bone are impacted (pushed together firmly) by the fall, the bone can heal naturally. In this case, your health care provider may prescribe painkillers, bed rest, and physical therapy for a few weeks to allow healing.

More often, however, the ends of the bone are separated and out of line. When this happens, surgery is needed to either repair the bone or replace the hip joint. The choice of surgical treatment will depend on where the break is and any other medical conditions you may have.

Physical therapy will help you rebuild muscle strength and start walking again.

How can I take care of myself?

• Follow the treatment plan prescribed by your health care provider and physical therapist.
• Follow your health care provider's recommendations for controlling osteoporosis.
• Wear well-fitting flat shoes. Avoid wearing high heels and sandals with light straps. Avoid shoes with soles that are too slippery or too sticky, such as some crepe or rubber soles.
• Use a cane or walker if you have been advised to do so.
• Prevent falls in your home with good lighting. Don't leave electric cords in places where they might be tripped over. Arrange furniture so you don't bump into or fall over it.
• Have nonslip floors and avoid wet floors. Don't use area rugs that you could trip over.
• Install grab bars in your bathroom. Put nonskid tape in your bathtub and shower.
• Be sure that stair treads and handrails are firmly in place.
• Do not sit in chairs that lean back too far, since getting up from these chairs can cause problems in the hips.
• Eat more calcium-rich food: dairy products, green vegetables, citrus fruit, and sardines. Ask your health care provider if you should take calcium supplements.
• Estrogen hormone therapy after menopause has been shown to slow the bone thinning process. In the past, hormone therapy has been suggested for women at risk for osteoporosis. However, there are risks that go along with hormone therapy. Discuss the risks and benefits with a health care provider who is familiar with your health history. There are other medicines and lifestyle changes that can be used to help prevent osteoporosis that are less risky.
• Try to exercise daily, according to the advice of your health care provider or therapist. Walk a mile a day if you can, once you have healed.
• Maintain a healthy weight for your height.
• Avoid climbing, heavy lifting, and unusual vigorous physical activity. Do not use step stools or ladders to reach high places. Get help when you need it.
• If you smoke or drink alcohol, quit.