Overview

A Hip Fracture is a break in the upper part of the femur, or thigh bone, close to the hip joint. It is a serious injury that commonly occurs after a fall in older adults, particularly when bones have become weaker due to osteoporosis. In younger people, hip fractures are more often associated with high-impact injuries such as road accidents or sports-related trauma.

Common Hip Fracture Symptoms include severe pain around the hip or groin, difficulty standing or walking, swelling or bruising, and reduced movement of the affected leg. The leg may sometimes appear shorter or turned outward. Prompt medical assessment is important because delayed treatment can increase the risk of complications.

At Sarvodaya Hospital, our orthopaedic and trauma specialists provide comprehensive Hip Fracture Treatment based on the fracture location, bone quality, patient's age, overall health, and functional requirements. Treatment may include fracture fixation, hip replacement, pain management, and structured rehabilitation.

Symptoms of Hip Fracture

• Severe pain in the hip or groin
• Pain that may extend to the thigh
• Inability or difficulty standing
• Inability to put weight on the affected leg
• Difficulty walking
• Swelling around the hip
• Bruising
• Reduced hip movement
• Leg appearing shorter than the other
• Leg turning outward
• Severe discomfort when moving the affected leg

Causes of Hip Fracture

The Hip Fracture Causes vary according to age and bone health.

• Falls: A fall from standing height is one of the most common causes of hip fracture in older adults with weakened bones.
• Osteoporosis: Osteoporosis reduces bone strength and makes the hip more vulnerable to fractures even after relatively minor falls.
• Road Traffic Accidents: High-energy trauma can cause hip or upper femur fractures in younger adults.
• Sports Injuries: High-impact sports injuries can occasionally result in fractures around the hip.
• Direct Impact: A strong blow to the hip can cause a fracture, particularly when the bone is weakened.
• Previous Fractures: People who have previously experienced fragility fractures may have an increased risk of future fractures.

Risk Factors for Hip Fracture

Certain factors can increase the likelihood of a hip fracture.

• Increasing Age : Bone density and muscle strength may decrease with age, increasing the risk of falls and fractures.
• Osteoporosis : Weak bones are more susceptible to fractures following relatively minor trauma.
• Previous Falls : A history of falling increases the risk of future hip injuries.
• Reduced Muscle Strength : Weakness and reduced balance can increase the likelihood of falls.
• Vision Problems : Poor vision may increase the risk of tripping and falling.
• Certain Medications : Some medicines can affect balance, alertness, or bone health and may contribute to fracture risk.
• Poor Nutrition : Inadequate calcium, vitamin D, protein, and other nutrients can affect bone and muscle health.

Diagnosis of Hip Fracture

Accurate Hip Fracture Diagnosis helps determine the location and severity of the fracture and guides treatment planning.

• Clinical Examination : The orthopaedic trauma specialist assesses pain, swelling, leg position, movement, circulation, sensation, and the patient's ability to bear weight.
• X-Ray : X-rays are usually the first imaging test used to identify a hip fracture and determine its location and pattern.
• CT Scan: CT may be recommended when the fracture pattern requires more detailed assessment or when an X-ray does not provide sufficient information.
• MRI: MRI can identify fractures that may not be clearly visible on initial X-rays and can provide detailed information about surrounding soft tissues.
• Bone Health Assessment: In older adults, doctors may evaluate bone health and assess for osteoporosis after a fragility fracture. Blood tests may also be performed to identify nutritional or metabolic factors affecting bone health.

Treatment Options for Hip Fracture

The most appropriate Hip Fracture Treatment depends on the fracture type, location, displacement, bone quality, age, general health, and functional needs.

• Hip Fracture Surgery: Most displaced hip fractures require surgical treatment to stabilise the bone or replace the damaged portion of the hip joint. Surgery is generally planned as soon as the patient is medically fit because prolonged immobility can increase the risk of complications.
• Internal Fixation: Some fractures can be treated using screws, plates, or specialised intramedullary implants to hold the broken bone in the correct position while it heals.
• Hip Replacement After Hip Fracture: May be recommended for selected patients, particularly older adults with certain fractures of the femoral neck where preserving the damaged femoral head may not provide reliable results.
• Femur Fracture Treatment: Depends on the exact location of the fracture. Upper femur fractures may be treated using internal fixation or hip replacement, while other femoral fractures may require specialised fixation techniques.
• Elderly Hip Fracture Treatment: Elderly Hip Fracture Treatment requires more than treating the broken bone. Older patients may have other medical conditions that need to be stabilised before and after surgery.

Benefits of Early Hip Fracture Treatment

Timely treatment can help restore mobility and reduce complications associated with prolonged immobility.

• Restores Stability: Surgical fixation or replacement helps restore structural stability to the hip and upper femur.
• Supports Early Mobilisation: Appropriate treatment allows patients to begin movement and rehabilitation as early as medically appropriate.
• Reduces Pain: Stabilising the fracture or replacing a damaged joint can significantly reduce fracture-related pain.
• Helps Prevent Complications: Early mobilisation may reduce complications associated with prolonged bed rest, including blood clots, chest infections, pressure injuries, and muscle weakness.
• Supports Independence: Appropriate rehabilitation can help patients return to daily activities and maintain independence.
• Improves Functional Recovery: Early treatment combined with physiotherapy can support better mobility and overall recovery.

Complications if Left Untreated

• Persistent pain
• Loss of mobility
• Blood clots
• Chest infections
• Pressure injuries
• Muscle weakness
• Loss of independence
• Delayed or abnormal bone healing
• Bone healing in an incorrect position
• Femoral head blood supply problems in certain fractures
• Joint stiffness
• Increased risk of further falls

When Should You See an Orthopaedic Trauma Specialist?

• Severe hip or groin pain
• Inability to stand
• Inability to walk
• Inability to put weight on the leg
• Significant swelling or bruising
• A leg that appears shorter or rotated
• Severe pain when moving the hip
• Persistent hip pain after a fall

Prevention & Lifestyle Modifications

Not all hip fractures can be prevented, but several measures can reduce the risk.

• Maintain Bone Health : Adequate calcium, vitamin D, protein, and other nutrients support healthy bones.
• Screen for Osteoporosis : Older adults and people with risk factors should discuss bone-density assessment with their doctor.
• Improve Muscle Strength: Appropriate strength and balance exercises can help reduce the risk of falls.
• Make the Home Safer: Remove loose rugs, improve lighting, install support rails where required, and keep frequently used items within easy reach.
• Manage Vision Problems: Regular eye examinations and appropriate vision correction can reduce fall risk.
• Review Medicines: Ask your doctor to review medicines that may cause dizziness, drowsiness, or balance problems.
• Use Appropriate Footwear: Comfortable, well-fitting footwear with suitable grip can improve stability.
• Follow Osteoporosis Treatment: Patients diagnosed with osteoporosis should follow their doctor's treatment plan to reduce the risk of future fractures.

Hip Fracture Surgery Recovery Time

Hip Fracture Surgery Recovery Time varies depending on the fracture type, surgery performed, age, general health, bone quality, and rehabilitation progress.

Many patients are encouraged to begin sitting, standing, and walking with assistance as soon as medically appropriate after surgery. Physiotherapy is an important part of recovery.

Recovery may take several weeks to months. Older patients or those with multiple medical conditions may require a longer rehabilitation period.

The treating orthopaedic team provides individual guidance on weight-bearing, walking aids, exercises, and return to daily activities.

Pre- and Post-Treatment Care

Pre-Treatment

• Orthopaedic trauma consultation
• X-ray
• CT or MRI when required
• Blood investigations
• ECG
• Anaesthesia assessment
• Medical evaluation for existing conditions
• Bone health assessment
• Medication review
• Surgical planning

Post-Treatment

• Prescribed pain management
• Wound care
• Early mobilisation
• Physiotherapy
• Walking with appropriate support
• Blood clot prevention as advised
• Nutritional support
• Calcium and vitamin D assessment
• Osteoporosis treatment when indicated
• Fall prevention
• Regular orthopaedic follow-ups
• Monitoring the surgical site and implant