Hip Fractures

Summary

Hip fractures are a serious injury, especially in older adults. They usually happen after a fall and can cause a lot of pain, making it difficult or impossible to walk. There are different types of hip fractures, and most require surgery to heal properly. Two of the most common types are intertrochanteric fractures and femoral neck fractures. With the right treatment and care, most people can recover and return to daily activities.

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Who is at Risk for a Hip Fracture

Hip fractures often happen after a fall, especially in older people who may have weaker bones due to conditions like osteoporosis. Women over the age of 65 are at the highest risk. These injuries can also happen in younger people, but usually only after a high-impact accident, like a car crash or a fall from a great height. Risk increases if someone takes certain medications that weaken the bones or has a history of falling.

Types of Hip Fractures

There are two main types of hip fractures. Intertrochanteric fractures occur in the area between two large bony bumps on the upper thigh bone. These fractures happen outside the hip joint. Femoral neck fractures happen just below the ball of the hip joint. These are located inside the joint and can sometimes interrupt blood flow to the bone, which may lead to complications like bone death or arthritis.

Intertrochanteric Hip Fractures

An intertrochanteric hip fracture happens between the greater and lesser trochanters of the thigh bone (Figure 1). This type of fracture is usually caused by a simple fall in older adults, especially women. It can cause pain, swelling, bruising, and make it hard to walk. Treatment usually involves surgery to hold the bone together using a dynamic hip screw or a trochanteric femoral nail. This helps the bone heal and lets the person move more quickly after surgery. To learn more about intertrochanteric hip fractures click on the link.

Femoral Neck Hip Fractures

A femoral neck fracture is a break in the narrow section of bone just below the ball of the hip joint (Figure 2). These fractures are tricky because they can cut off blood supply to the top of the thigh bone. There are two kinds: undisplaced, where the bone pieces are still in line, and displaced, where the bone is out of position. Undisplaced fractures might be treated with screws, but displaced fractures usually need either a partial hip replacement (Hemiarthroplasty) or a total hip replacement, especially in older adults. This helps avoid long-term problems like bone death (avascular necrosis) or poor healing. To learn more about femoral neck fractures click on the link.

Rehabilitation following a Hip Fracture

Rehabilitation after a hip fracture is an important part of recovery, especially for older adults. After surgery, most patients stay in the hospital for a few days. During this time, doctors and nurses help manage pain and make sure there are no problems from surgery. Once the patient is stable, the next step is to start moving again as soon as it is safe. Physical therapists help patients stand, walk, and do exercises to make their muscles stronger. These exercises are important for regaining balance, preventing falls, and helping the hip heal.

In many cases, patients go to a rehabilitation center or receive therapy at home. The goal is to get back to daily activities like walking, dressing, and bathing. Occupational therapists may help patients learn safe ways to move and use tools like walkers or grab bars. It’s also important to make the home safer by removing tripping hazards and adding things like handrails. Eating healthy foods and taking medicine for bone strength, like calcium or vitamin D, can help healing too. Rehabilitation takes time and effort, but with support, most people can return to their normal routines.

Prognosis Following a Hip Fracture

The outlook, or prognosis, after a hip fracture in an older person can vary. Many people are able to recover and return to their usual activities, but the healing process can be slow and depends on the person’s overall health. One of the most important parts of recovery is getting the patient up and moving as soon as it is safe after surgery. Walking and doing light exercises early on helps keep the muscles strong and prevents serious problems like blood clots, pneumonia, or bedsores. Staying active also helps the bones heal and reduces the risk of falling again.

However, for some older adults—especially those who were already weak, very sick, or mostly unable to walk before the injury—a hip fracture can be very serious. In these cases, the person may not be able to get back on their feet, and this can lead to a slow decline. The biggest risk isn’t usually the fracture or the surgery itself, but the loss of movement that follows. When a person is stuck in bed for too long, their body becomes weaker, and this can lead to life-threatening problems. That’s why helping patients move early and safely is so important for their survival and quality of life.

In summary, hip fractures are common and serious injuries, especially in older adults. Understanding the different types of fractures and how they are treated can help patients and their families make informed decisions. With proper care and treatment—usually surgery—most people can recover and get back to their regular activities.

Edited by Stephen Pinney MD, November 6th 2025