Condition Basics

What is a hip fracture?

A hip fracture is a break in the upper part of the thigh bone (femur). It usually happens near where the thigh bone fits into the hip joint. A hip fracture almost always completely breaks the bone. It can take some time to recover. But treatment can help you get back some strength and mobility.

What causes it?

Most hip fractures are caused by falls. As you get older, your bones naturally lose some strength and are more likely to break, even from a minor fall. Children and young adults are more likely to break a hip because of a bike or car crash or a sports injury.

What are the symptoms?

If your hip is broken, you will most likely:

• Have severe pain in your hip or lower groin area.
• Not be able to walk or put any weight on your leg.

These symptoms are most common after a fall. But if you have very thin bones from osteoporosis or another problem, you could break your hip without falling.

In rare cases, people have only thigh or knee pain. They may be able to walk.

How is it diagnosed?

Doctors use X-rays to diagnose a broken hip. You may need another test if your doctor thinks that you have a fracture but can't see it on an X-ray. You might have a test such as:

• An MRI, which gives better images of bones and soft tissues.
• A CT scan, another way of getting more detailed images.
• A bone scan, which involves injecting a dye, then taking images. It can show hairline fractures, where the bone is cracked but the pieces are still in place.

How is a hip fracture treated?

You will most likely need surgery to fix your hip. Surgery usually works well, but your hip will probably take a long time to get better.

Surgery is done as soon as possible after a hip fracture is diagnosed, often within 24 hours. Having surgery right away may help shorten your stay in the hospital. It can also reduce pain and problems from the surgery. Sometimes surgery is delayed for 1 to 2 days so other medical problems can be treated first.

The type of surgery you have will depend on where the break is and how bad it is.

• Hip repair surgery is called internal fixation or "hip pinning." The doctor uses metal screws, rods, or plates to hold the bone together while it heals. This surgery is usually chosen if the bones can be lined up properly.
• Hip replacement surgery involves replacing part or all of the joint with artificial parts. In a partial hip replacement, the doctor replaces the broken upper part of the thigh bone. In a total hip replacement, both the hip socket and the top of the thigh bone are replaced. Total hip replacement is often done when the fractured bones can't be properly lined up.

Your doctor will encourage you to take part in a rehab program that includes physiotherapy and occupational therapy. This will teach you:

• Exercises to help you regain your strength and mobility.
• New ways to do simple daily activities.
• Safe ways to stay active.

Taking part in a rehab program is very important because it will speed up your recovery. Rehab can also help you get back to your normal activities sooner.

How can you prevent it?

There are many things you can do to prevent a hip fracture. One of the most important is to prevent osteoporosis. Bone thinning can happen to men or women. But it is more common in women.

To keep your bones strong:

• Get plenty of calcium and vitamin D. Dairy foods like milk, cheese, and yogurt have lots of calcium. It's also in some vegetables like broccoli and kale. Vitamin D is in foods such as salmon, tuna, and fortified milk and soy beverages. Health Canada and Osteoporosis Canada recommend that Canadian adults take daily vitamin D supplements.^{footnote 1} Ask your doctor how much you need.
• Limit alcohol. Osteoporosis Canada recommends drinking no more than an average of two alcoholic drinks daily.
• Do weight-bearing exercise that puts pressure on bones and muscles. Walking is a good choice.
• If your doctor prescribes medicine to slow osteoporosis, take it as directed.
• Don't smoke.

You also need to be extra careful to prevent falls. Here are a few ways to make your home safer:

• Keep walkways clear of electrical cords and clutter.
• Be sure you have good lighting where you are walking.
• Put grab bars and non-slip mats in showers and tubs.

It can also help to:

• Get your eyes checked on a regular basis.
• Exercise to help keep your strength and balance.
• Take medicines as directed. And from time to time, ask your primary care doctor to review your medicines. Some medicines, such as sleeping pills or pain relievers, can increase your risk of falling.