Hip fracture

A hip fracture is a break at the top of your thigh bone (the femur). They most commonly occur due to a fall or impact to the side of the hip, for example, a fall or a car accident.

Your risk of a hip fracture increases as you age and most often occurs in people aged around 80 years old. This is because:

• You're more likely to fall as you get older
• Your bones become weaker as you age

There are various reasons you're more likely to fall:

• Poor vision and balance problems
• Certain medications and medical conditions that affect balance
• Physical inactivity reducing muscle and bone strength

You're also more susceptible to fractures if you suffer from a condition that weakens bones. The most common is osteoporosis – a condition that results in loss of bone density and is most likely to affect women after the menopause. For this reason, women are more likely than men to suffer from a broken hip.

You can also have weakened bones due to:

• Cancer
• Previous stress injury (due to overuse)
• Malnutrition (lack of vitamin D or calcium)

In cases of extreme bone weakness, you can even suffer a fracture simply by twisting or standing awkwardly.

If you suspect you have a broken hip, you need to go to A&E immediately. Symptoms include:

• Severe pain in your groin or hip area
• Inability to move your leg
• Being unable to put weight on your leg
• Stiffness, bruising and swelling
• A shorter leg that may be turned outwards on your injured side

Once you've arrived at hospital, you'll have an X-ray and possibly an MRI or CT scan if the X-ray was unable to confirm a break.

The most common treatment for a hip fracture is surgery and will be carried out as soon as possible for a better outcome. The type of surgery you require depends on:

• Where the fracture is on your thigh bone
• Your age
• How physically fit you are
• Your ability to take part in the physiotherapy following the operation
• The overall health of your joint

There are three main types of surgery.

Total hip replacement

Both the top of your thigh bone and socket are replaced. It's required in around half of cases and recommended if you have arthritis.

Partial hip replacement

Only the top of your thigh bone is replaced with a prosthesis. This is recommended when the fracture has occurred inside the socket of the hip joint (an intracapsular or femoral neck fracture).

Internal fixation

Pins, screws and rods are inserted into the bone to keep it together while it heals. It can be used when the break is outside the socket or inside, but the bones haven't been displaced.

After surgery, a physiotherapist will help promote healing using massage, manipulation and gentle exercise.

Very rarely, surgery isn't an option. This may be because you’re too frail or the break happened earlier and has already started to heal. If so, healing can take longer and usually requires bed rest.