Overview

Factors that may contribute to a hip fracture include:

• falls, the most frequent cause of hip fractures
• osteoporosis, a bone-thinning disease that weakens all bones including the hip
• motor vehicle accidents and other types of major trauma
• stress fractures in athletes (rare)
• bone diseases such as osteomalacia (rare)
• bone tumours (rare)

Risk factors that increase your chances of fracturing your hip include:

• previous hip fracture or history of falling
• age: 65 years or older
• sex: female (especially after menopause)
• heredity
• family history of fractures later in life
• small-boned, slender body (low body weight)
• Caucasian or Asian race
• others:
  • deficient intake or absorption of calcium (pdf file) and vitamin D
  • smoking
  • excessive alcohol use
  • physical inactivity
  • chronic disease or fragile health
  • difficulties with activities of daily living
  • poor balance and coordination
  • irregular heart beat or low blood pressure
  • problems with vision
  • arthritis
  • Parkinson's disease
  • stroke
  • mental impairments including Alzheimers disease
  • certain medications which cause dizziness, drowsiness, or weakness
  • systemic cortisone
  • excess thyroid hormone

Diagnosis

Symptoms may include:

• pain in the hip
• difficulty or inability to stand, walk or move the hip
• abnormal appearance of the broken leg—it looks shorter or turns outward

The doctor will ask about your symptoms, how the injury occurred, and then will perform a physical exam. Tests may include:

• x-rays
  These will help to determine exactly where the bone is broken and how far out of place the pieces have moved.
• bone scan or magnetic resonance imaging (MRI) scan
  These tests are used if the fracture doesn't show up on x-rays but symptoms indicate a fracture has occurred.

Treatment Options

The goal is to get you back on your feet again as quickly as possible while your broken bone heals. Treatment includes:

• prompt emergency treatment
  • taking all weight off the injured leg and immobilizing the fracture
  • checking vital signs such as blood pressure
  • treating problems such as internal blood loss
  • controlling pain with pain killers and other drugs
• surgery
  • Surgery is performed to set the broken bone and hold it in the correct position. This may involve:
  • inserting a surgical plate and screws at the fracture site
  • replacing the hip with a metal implant (prosthesis), which has a ball that fits into the hip socket and an attached stem which goes into the thigh bone to hold the implant in place.
• physical assistance
  • exercises or therapy to help you return to your normal level of activity
  • a cane or walker as advised by your doctor
  • aid with activities of daily living until you can return to normal activity

Prevention

Early corrective action may help alleviate many of the factors that can lead to a hip fracture. Here's what you can do:

• eat a diet with nutrients for strong bones:
  • calcium (pdf file): about 1,000 milligrams daily, but check with your doctor
  • vitamin D: 400-800 units a day
  • adequate protein intake
• exercise:
  • Ask your doctor before starting any exercise program.
  • weight-bearing activities such as walking
  • strengthening exercises, both upper and lower extremities
• See your doctor if you are at risk for osteoporosis. Preventive medication may include:
  • hormone replacement therapy for women after menopause
  • biphosphonates
  • calcitonin
• Ask your provider if any of your medications may contribute to:
  • bone loss
  • dizziness, drowsiness, or confusion
• Get your eyes checked regularly.
• Reduce falling hazards at work and home:
  • Clean spills and slippery areas immediately.
  • Remove tripping hazards such as loose cords, rugs and clutter.
  • Use non-slip mats in the bathtub and shower.
  • Install grab bars next to the toilet and in the shower or tub.
  • Put in handrails on both sides of stairways.
  • Walk only in well-lighted rooms, stairs, and halls.
  • Keep flashlights nearby in case of a power outage.