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What is a hip fracture?
A hip fracture is a break in the bones of your hip (near the top of your leg). It can happen at any age, although it is more common is people 65 years of age and older. As you get older, the inside of your bones becomes porous from a loss of calcium. This is called losing bone mass. Over time, this weakens the bones and makes them more likely to break. Hip fractures are more common in women, because they have less bone mass to start with and lose bone mass more quickly than men.
What are the symptoms of a hip fracture?
Hip fractures usually are caused by a fall. If you fracture your hip, you may experience the following symptoms:
- Severe pain in your hip or pelvic area
- Bruising and/or swelling in your hip area
- Inability to put weight on your hip
- Difficulty walking
- The injured leg may look shorter than the other leg and may be turned outward
DIAGNOSIS & TESTS
How will my healthcare provider know I have a hip fracture?
Any time you fall and are unable to get up or stand, contact your healthcare provider right away. They may take an X-ray to check for hip fracture.
How is a hip fracture treated?
Most people who have hip fractures will need surgery to make sure the leg heals properly. Your healthcare provider will discuss your surgery options with you.
Some people are unable to have hip surgery because of an illness or poor health. If your healthcare provider doesn’t think it’s safe for you to have surgery, you will be put into traction to help your hip heal. Traction keeps you immobile for a long period of time.
What can I expect after surgery?
Your healthcare provider can tell you when you should try to stand or walk after surgery. It may be painful to walk at first. You may need a walker or cane for assistance for several months after surgery.
You may need to see a physical therapist as part of your recovery. In physical therapy, you’ll learn to sit, stand and walk without reinjuring your hip. You’ll also do exercises to help you get stronger.
When you return home after your surgery, you may need some help from a home nurse or family member. Daily tasks may be difficult to perform while you aren’t able to move around very well. A family member or nurse can help you with your daily tasks, such as bathing, cooking and shopping.
What about complications?
A hip fracture is a serious injury, but the complications from a hip fracture can be severe or even life-threatening. If you are immobile for a long period of time after your surgery, or if you are in traction, you are at risk of developing deep vein thrombosis. Deep vein thrombosis (also called DVT) is a blood clot in a vein deep inside your body. These clots usually occur in your leg veins. If the blood clot breaks away and travels through your bloodstream, it could block a blood vessel in your lungs. This blockage (called a pulmonary embolism) can be fatal.
Other complications from immobility after hip surgery can include:
- Pressure sores
- Muscle wasting or atrophy
- Urinary tract infections
How can I prevent another hip fracture?
To help prevent a hip fracture, you should:
- Get regular physical activity to keep your bones and muscles strong.
- Don’t drink or smoke.
- Eat and drink more products with calcium (for example: milk, cottage cheese, yogurt, sardines and broccoli) to keep your bones strong.
- Take vitamin D each day, which helps your body absorb calcium. Your healthcare provider can tell you how much vitamin D is safe for you.
- If your healthcare provider suggests that you use a cane or a walker to help you walk, be sure to use it. This will give you extra stability when walking and will help you avoid a bad fall.
- See your eye healthcare provider once a year. You are more likely to fall if you can’t see well because of cataracts or other eye diseases.
- Ask your healthcare provider about medicines that can keep your bones strong and about products that can protect your hips if you fall.
- Make your house safer. Make sure that you have good lighting in your home, which will help you avoid tripping over objects that are not easy to see. Put night lights in your bedroom, hallways and bathrooms. Rugs should be firmly fastened to the floor or have non-skid backing. Loose ends of rugs and carpets should be tacked down. Electrical cords should not be lying on the floor in walking areas. Put hand rails in your bathroom for bath, shower and toilet use. Have rails on both sides of your stairs for support. Be sure the stairs are well lit.
QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER
- Am I at risk for a hip fracture?
- Should I take a medicine to strengthen my bones?
- Can you recommend some exercises I can do to get stronger?
- How can I prevent falls in my home?
- What is the best treatment for me?
- How long will my recovery take after surgery?
- Will I need physical therapy?
- How can I avoid getting a pressure sore?
- Should I wear compression stockings after surgery?
- What exercises are safe after surgery?
Management of Hip Fracture: The Family Physician’s Role by SS Rao, M.D., and M Cherukuri, M.D. (06/15/06, http://www.aafp.org/afp/20060615/2195.html)