Hip fractures are cracks or breaks in the top of the thigh bone (femur) close to the hip joint.
Doctors sometimes refer to hip fractures as proximal femoral fractures.
The hip joints
The hip joints attach your thigh bones (femurs) to your pelvis.
Hip joints are ball-and-socket joints. The ball is the rounded top part of the femur. The socket is the cup-shaped part of the pelvic bone that the rounded end of the femur sits inside.
A hip fracture is a crack or break in the top end (neck) of the femur, nearest the hip joint. It can either occur in the part of the femur inside the socket of the hip joint (intracapsular), or outside the socket (extracapsular).
Symptoms of a hip fracture
Symptoms of a hip fracture include:
- not being able to lift, move or rotate (turn) your leg
- being unable to stand or put weight on your leg, although in some cases this is possible
- a shorter leg, or your leg turning outwards more on the injured side
If you think you've fractured your hip, you'll need to go to hospital as soon as possible. Dial 999 to request an ambulance.
Try not to move while you're waiting for the ambulance and make sure you keep warm.
What causes hip fractures?
Hip fractures are often the result of a fall. Falls are very common in older people due to other health problems, such are reduced vision and mobility and balance problems.
A fall can cause a hip fracture if a person has osteoporosis (weak and fragile bones).
Some people find it hard to recover after a hip fracture, up to one in three people die within 12 months of fracturing their hip (although most deaths aren't caused by the fall itself but by pre-existing illnesses).
This is why the National Institute for Health and Care Excellence (NICE) recommends a co-ordinated programme of care for people who've fractured a hip (see below).
Treating a hip fracture
Surgery is usually the only treatment option for hip fractures.
NICE recommends that someone with a hip fracture should have surgery on the day they're admitted to hospital or the day after being admitted.
In about half of all cases, a partial or complete hip replacement is needed. The rest require surgery to fix the fracture with plates and screws or rods.
The type of surgery you have will depend on a number of factors, including:
- type of fracture (where on the femur it is)
- your age
- your level of mobility before the fracture
- the condition of the bone and joint – for example, whether you have arthritis
Read more about treating a hip fracture.
Recovering from hip surgery
The aim after surgery is to speed up recovery to help regain your mobility.
The day after surgery, you should have a physiotherapy assessment and be given a rehabilitation programme that includes realistic goals for you to achieve during your recovery. The aim is to help you regain your mobility and independence so that you can return home as soon as possible.
Read more about your care after discharge from hospital.
How long you'll need to stay in hospital will depend on your condition and mobility. After having a hip replacement, it may be possible for you to be discharged in three to five days.
Evidence suggests that prompt surgery and a tailored rehabilitation programme that starts as soon as possible after surgery can significantly improve a person's life, reduce the length of their hospital stay and help them recover their mobility faster.
Read more about recovering from a hip fracture.
It may also be useful to read your guide to care and support – written not only for people with care and support needs, but their carers and relatives too. It includes information and advice on:
- transport and getting around with mobility issues
- rehabilitation or 'reablement' services
- choosing mobility equipment, wheelchairs and scooters
Complications of hip surgery
Complications that can occur after a hip operation include:
- infection – occurs in about 1-3% of cases
- blood clots – can form in the deep veins of the leg (deep vein thrombosis); they can be prevented using compression stockings, exercise and medication
- pressure ulcers – can develop on an area of skin that's under constant pressure due to being in a chair or bed for long periods
Your surgeon will be able to discuss these and any other risks with you.
Read more about the complications of a hip fracture.
Preventing hip fractures
It may be possible to prevent hip fractures by taking steps to prevent falls and by treating osteoporosis.
You can reduce your risk of falling by:
- using walking aids, such as a walking stick
- assessing your home for hazards – such as loose carpeting – and making it safer
- using exercises to improve your balance
Major public health issue
Hip fractures are a major public health issue due to an ever increasing ageing population (80 is the average age of a person who has a hip fracture).
Around 70,000-75,000 hip fractures occur in the UK each year. The annual cost for all hip fractures in the UK, including medical and social care, is about £2 billion.
Hip fractures are more common in women due to the higher incidence of osteoporosis (weak and fragile bones) in women.