Broken hip

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).

Read more about the causes of a hip fracture.

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.

How long you'll need to stay in hospital will depend on your condition and mobility. After a having 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.

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

Read more about preventing falls and preventing hip fractures.