Hip fracture
A hip fracture is a break that occurs in the upper part of the femur (thigh bone), at the femoral neck or (rarely) the femoral head. Symptoms may include pain around the hip, particularly with movement, and shortening of the leg. Usually the person cannot walk.
| Hip fracture | |
|---|---|
| Other names | Proximal femur fracture; femoral neck fracture [main hyponym]; femoral head fracture [other hyponym] |
| Intertrochanteric hip fracture in a 17-year-old male | |
| Symptoms | Pain around the hip particularly with movement, shortening of the leg |
| Types | Intracapsular, extracapsular (intertrochanteric, subtrochanteric, greater trochanteric, lesser trochanteric) |
| Causes | Trauma such as a fall |
| Risk factors | Osteoporosis, taking many medications, alcohol use, metastatic cancer |
| Diagnostic method | X-ray, MRI, CT scan, bone scan |
| Differential diagnosis | Osteoarthritis, avascular necrosis of the hip, hernia, trochanteric bursitis |
| Prevention | Improved lighting, removal of loose rugs, exercise, treatment of osteoporosis |
| Treatment | Surgery |
| Medication | Opioids, nerve block |
| Prognosis | ~20% one year risk of death (older people) |
| Frequency | ~15% of women at some point |
A hip fracture is usually a femoral neck fracture. Such fractures most often occur as a result of a fall. (Femoral head fractures are a rare kind of hip fracture that may also be the result of a fall but are more commonly caused by more violent incidents such as traffic accidents.) Risk factors include osteoporosis, taking many medications, alcohol use, and metastatic cancer. Diagnosis is generally by X-rays. Magnetic resonance imaging, a CT scan, or a bone scan may occasionally be required to make the diagnosis.
Pain management may involve opioids or a nerve block. If the person's health allows, surgery is generally recommended within two days. Options for surgery may include a total hip replacement or stabilizing the fracture with screws. Treatment to prevent blood clots following surgery is recommended.
About 15% of women break their hip at some point in life; women are more often affected than men. Hip fractures become more common with age. The risk of death in the year following a fracture is about 20% in older people.