Hip Fracture

What we often call a hip fracture is actually a fracture of the upper part or neck of the femur (thighbone). The fracture occurs where the femur meets the pelvis. It is more common in people with osteoporosis. Osteoporosis is a disease in which bones become thin after middle age.

Most hip fractures occur in women after menopause. Each year there are approximately 200,000 hip fractures in the United States and about 20 percent of those people die within six months of their fracture. By the age of 90, 32 percent of women and 17 percent of men will have suffered a hip fracture.

How does it occur?

Hip fractures usually result from a fall. Because osteoporosis weakens the bones and makes them much more likely to break, hip fractures occur more often as men and women get older. In this country alone, 20 to 25 million people suffer from osteoporosis, and nearly half of older Americans have this disease.

What are the symptoms?

• You have severe pain in your hip.
  
• You cannot bear to move or put any weight on your leg.
  
• You have stiffness, bruising, and swelling in your hip.
  
• Your leg is shortened or turns either inward or outward.
  

How is it diagnosed?

Your doctor will review your medical history and examine your hip. Often the fracture is obvious from the abnormal position of the hip and leg.

An x-ray usually shows the fracture. It will also suggest osteoporosis if you have it.

How is it treated?

If the ends of the broken bone are impacted (pushed together firmly) by the fall, the bone can heal naturally. In this case, your doctor may prescribe painkillers, bed rest, and physical therapy for a few weeks to allow healing.

Much more often, however, the ends of the bone are separated and out of line. When this happens, surgery is needed to either repair the bone or replace the hip joint. The choice of surgical treatment will depend on where the break is and on your other medical conditions.

Physical therapy will help you rebuild muscle strength and start walking again after surgery.

How can I take care of myself?

• Follow the treatment plan prescribed by your doctor and physical therapist.
  
• Follow your doctor's recommendations for controlling osteoporosis.
  
• Wear well-fitting flat shoes. Avoid wearing high heels and sandals with light straps. Avoid shoes with soles that are too slippery or too sticky, such as some crepe or rubber soles.
  
• Use a cane or walker if you have been advised to do so.
  
• Prevent falls in your home with good lighting. Don't leave electric cords around to trip over. Arrange furniture so you don't bump into or fall over it.
  
• Have nonslip floors and avoid wet floors. Don't use area rugs that you could trip over.
  
• Install grab bars in your bathroom. Put nonskid tape in your bathtub and shower.
  
• Be sure that stair treads and handrails are firmly in place.
  
• Eat calcium-rich foods: dairy products, green vegetables, citrus fruit, and sardines.
  
• If you are postmenopausal, consider medical therapy, if you are not doing so already. Discuss this with your doctor.
  
• Try to exercise daily, according to the advice of your health care provider or therapist. Walk daily if you can, once you have healed. Avoid climbing, heavy lifting, and unusual vigorous physical activity. Do not use step stools or ladders to reach high places. Get help when you need it.
  
• If you smoke or drink alcohol, quit.
  

Developed by Ann Carter, MD, for iMcKesson Clinical Reference Products.
Published by iMcKesson Clinical Reference Products.

Adapted from content provided by iMcKesson, LLC
Review Date: 6/9/01