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Hip Fracture

A hip fracture is a break in the femur (thigh bone) of the hip joint.

Hip fractures are serious and require immediate medical attention. People who sustain one are more likely to die than a person of the same age who does not experience this injury. About 20 percent of people who have a hip fracture die within a year of their injury. It is estimated that only one in four persons have a total recovery from a hip fracture. 

About 90 percent of hip fractures occur in people age 60 and older. In fact, the incidence of hip fractures doubles each decade after age 50. Because Caucasian and Asian females have a higher rate of osteoporosis, they experience about 60 percent of all hip fractures.

Hip fracture types

A fracture can be partial or complete, and there can be a single break or multiple ones in a bone. The most common types of hip fractures are:

  • Femoral neck fracture. A femoral neck fracture occurs one to two inches from the hip joint. These  fractures are common among older adults and can be related to osteoporosis. This  type of fracture may cause a complication because the break usually cuts off the  blood supply to the head of the femur, which forms the hip joint.
  • Intertrochanteric hip fracture. An intertrochanteric hip fracture occurs three to four inches from the hip joint. This type of fracture does not interrupt the blood supply to the bone and may be easier to repair.
  • Stress fracture. Less common than other types of hip fractures, a stress fracture is a hairline crack in the femur that may not involve the entire bone. Stress fractures are caused by overuse and repetitive motion, and the symptoms are often similar to those of tendonitis or muscle strain.


In the elderly, a fall is the most common reason for a hip fracture. In the young, hip fractures can occur as a result of a car accident, a fall or severe trauma. Occasionally, hip fractures can occur spontaneously.

Hip fracture is more common in older people because bones become thinner and weaker from calcium loss as a person ages, generally due to osteoporosis. Most hip fractures sustained by older people occur as a result of falling while walking on a level surface, often at home.

As women age, they lose 30 percent to 50 percent of their bone density. After menopause, bone loss accelerates because of reduced estrogen production. Estrogen helps maintain bone strength and density.

Risk factors

The leading causes of hip fracture are osteoporosis and age. Other things that may increase your risk of a hip fracture include:

  • Excessive alcohol or caffeine consumption
  • Sedentary lifestyle
  • Low body weight
  • Tall stature
  • Vision problems
  • Dementia
  • Taking medications that cause bone loss
  • Smoking
  • Institutional living, such as an assisted-care facility
  • Conditions that cause weakness, unsteady gait or difficulty walking


The symptoms of a hip fracture can vary from person to person, and they often resemble other medical conditions. Signs of a problem may include:

  • Hip pain and/or pain that can be felt in the knee
  • Low back pain
  • Inability to stand or walk
  • Bruising or swelling
  • Foot turned out at an odd angle, making the leg look shorter

Consult your physician for a conclusive diagnosis.


In addition to a complete medical history and physical examination, diagnostic procedures for hip fracture may include the following:

  • X-ray. A diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • MRI. Magnetic resonance imaging uses a combination of large magnets, radiofrequencies and a computer to produce detailed images of organs and structures within the body.
  • Computed tomography scan. CT scans use a combination of X-rays and computer technology to produce horizontal images (often called slices) of the body. CT scans are more detailed than standard X-rays, and show images of any part of the body, including bones, muscle, fat and organs. 


Treatment for a hip fracture depends on several factors, including:

  • Your age, overall health, and medical history
  • Extent of the condition
  • Your tolerance for specific medications, procedures or therapies
  • Expectation for the course of the condition
  • Your personal preference

A fracture of the hip is generally treated with surgery. Depending on the severity of the fracture, your doctor may use metal devices to strengthen and stabilize the joint. In some situations, a total hip replacement may be performed. 

The goal of treatment is to provide pain relief and return you to your normal activities. Hip surgery usually requires an in-hospital stay, as well as inpatient and outpatient physical therapy.


Serious complications can result from a hip fracture. They include:

  • Blood clots
  • Pneumonia
  • Muscle atrophy (wasting of muscle tissue)
  • Postoperative infection
  • Mental deterioration following surgery in older patients
  • Avascular necrosis


Preventing a hip fracture is more desirable than treating one. There are three major things you can do to avoid fracturing your hip:

  • Take enough calcium. The National Institutes of Health (NIH) recommends that post-menopausal women not taking estrogen consume 1,500 milligrams of calcium daily. For post-menopausal women taking estrogen, NIH recommends 1,000 mg of calcium per day. Middle-aged men should take 1,000 mg daily.
  • Monitor your bone density. Women who are at menopause should have the mineral content and thickness of their bones analyzed. Bone density tests are used to detect decreased bone mass, osteoporosis and fracture risk.
  • Engage in weight-bearing exercise. Walking, jogging and hiking can help prevent hip fracture. Exercises such as Tai Chi can improve your strength and balance.

Other steps you can take to prevent a fall or fractured hip include:

  • Take medications as prescribed by your doctor to prevent bone loss
  • Eat a calcium-rich diet including milk, cottage cheese, yogurt, sardines, and broccoli
  • Stop smoking
  • Avoid excessive alcohol use
  • Keep tripping hazards, such as electrical cords, out of the way
  • Use slip-resistant rugs next to the bathtub
  • Install grab bars in the tub
  • Position night lights from the bedroom to the bathroom
  • Use rug pads or nonskid backing to keep rugs in place
  • Avoid standing on unsteady furniture
  • Visit an ophthalmologist every year to have vision checked annually and vision loss treated

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