A broken hip is defined as a fracture in the upper portion of your thigh bone (femur). Your hip is a joint, which is a point where two or more bones come together. The top of your femur and part of your pelvic bone meet to form your hip. The hip is a ball and socket joint, where the ball is the head of the femur and the socket is a curved part of the pelvic bone called the acetabulum. The hip’s structure allows more range of movement than any other type of joint. For example, you can rotate and move your hips in multiple directions. Other joints such as the knees and elbows allow only limited movement in one direction.
A broken hip is a serious condition, especially if you are older. It almost always requires surgery. In addition, complications associated with a broken hip can be life threatening. If you suspect a broken hip, seek medical attention immediately.
A fracture usually occurs in the ball portion (femur) of your hip joint and can occur in different places. At times the socket (acetabulum) is affected as well.
Femoral Neck Fracture
This type of break occurs in the femur about one or two inches from where the head of the bone meets the socket. A femoral neck fracture may cut off the blood circulation to the ball of your hip by pressing on the blood vessels.
Intertrochanteric Hip Fracture
An intertrochanteric hip fracture occurs farther away from the joint and does not stop blood flow to the femur. The break may be about three to four inches away from the joint.
This fracture affects the ball and the socket portions of your hip.
A number of things may cause hip fractures. These include the following:
- falls to a hard surface or from a great height
- blunt trauma to the hip, such as from a car crash
- diseases such as osteoporosis, a condition that causes the loss of bone tissue
- obesity (too much weight may place great pressure on the hip bones)
The risk factors for a broken hip include:
If you are 60 or older, you may be at risk. As you age, the strength and density of your bones may deteriorate. This may leave you vulnerable to fractures because weak bones may break easily. In addition to bone deterioration, advanced age often brings vision and balance problems as well as other issues that make you more likely to fall.
WeightYour hips support almost all of the weight of your upper body. Excess weight may wear down your hip cartilage and cause the bones to rub together. This action may destroy healthy bone tissue.
EthnicityIf you are of Asian or Caucasian descent, you are at a higher risk for osteoporosis than people of other descents.
If you are a woman, your chances of bone fracture in the hip increase because you are more susceptible to osteoporosis than a man.
If you have previously had a broken hip, you are at a much greater risk for another hip break.
The symptoms for a broken hip include:
- pain in the hip and groin area
- the leg on the affected side may be shorter than the unaffected leg because a break has reduced bone length
- the inability to put weight or pressure on the affected hip and leg
- inflammation in the hip
Your doctor may notice the obvious signs of a broken hip (such as swelling and bruising). However, to make a correct diagnosis, he may order special tests to confirm his initial assessment.
Imaging tests help your doctor locate fractures. He may order X-rays to take pictures of your hip. If this imaging tool does not reveal any fractures, your doctor may use other methods.
- A magnetic resonance imaging (MRI) scan may show a break in the hip bone better than X-rays. This imaging tool produces many detailed pictures of the hip area. Your doctor can view these images on film or on a computer screen.
- A computed tomography (CT) scan is another imaging method that produces pictures of the hip bone as well as the muscles, tissues, and fat that surrounds it
Your doctor may take your age and physical condition into consideration before making a treatment plan. If you are older and have medical issues in addition to a broken hip, your treatment may vary based on these.
Your doctor may prescribe pain medication to reduce your discomfort. You might also be given prescription medications (such as bisphosphonates) to help increase your bones’ density. This will help prevent other fractures.
If you are healthy enough to withstand surgery, it is the most common treatment for a broken hip. You may have surgery to repair or replace your hip. Hip replacement surgery involves removing the damaged part of your hip and putting an artificial hip part in its place.
If you have surgery, your doctor may recommend physical therapy to help you recover faster. A therapist will teach you range of motion exercises (used to improve flexibility and movement) to help your body get used to a new or repaired hip.
Your recovery depends on your age and which area of the hip bone you broke. Although surgery is successful in most cases, you may have complications afterward. A broken hip can leave you unable to walk for a long time as you recover. This prolonged immobility can lead to:
- blood clots in your legs or lungs
- urinary tract infections
Broken Hips and the Elderly
Unfortunately, a broken hip can have a bleak prognosis if you are elderly. This is because of the risks associated with surgery for older people as well as the physical demands of recovery. After about a two-week stay in the hospital, you will likely need to spend time at a rehabilitation facility. If your recovery does not progress, you might need to go to a long-term care facility. The losses of mobility and independence can lead to depression in older people, and this might further impede recovery. According to the University of Chicago Medical Center, only one in four hip fracture patients makes a full recovery. About 20 percent of people die within one year of sustaining a broken hip. (University of Chicago) Because older adults are more likely to have broken hips, they are more affected by these statistics.
Written by: Brindles Lee Macon and Marijane Leonard
Medically reviewed by George Krucik, MD