Treatments and drugs

By Mayo Clinic Staff

Treatment for hip fracture usually involves a combination of surgery, rehabilitation and medication.

Surgery

The type of surgery you have generally depends on the location and severity of the fracture, whether the broken bones aren't properly aligned (displaced fracture), and your age and underlying health conditions. The options include:

  • Internal repair using screws. Metal screws are inserted into the bone to hold it together while the fracture heals. Sometimes screws are attached to a metal plate that runs down the femur.
  • Partial hip replacement. If the ends of the broken bone are displaced or damaged, your surgeon may remove the head and neck of the femur and install a metal replacement (prosthesis).
  • Total hip replacement. Your upper femur and the socket in your pelvic bone are replaced with prostheses. Total hip replacement may be a good option if arthritis or a prior injury has damaged your joint, affecting its function even before the fracture.

Your doctor may recommend partial or total hip replacement if the blood supply to the ball part of your hip joint was damaged during the fracture. That type of injury, which occurs most often in older people with femoral neck fractures, means the bone is less likely to heal properly.

Rehabilitation

Your care team will probably get you out of bed and moving on the first day after surgery. Physical therapy will initially focus on range of motion and strengthening exercises. Depending on the type of surgery you had and whether you have assistance at home, you may need to go from the hospital to an extended care facility.

In extended care and at home, you may work with an occupational therapist to learn techniques for independence in daily life, such as using the toilet, bathing, dressing and cooking. Your occupational therapist will determine if a walker or wheelchair may help you regain mobility and independence.

Medication

About 20 percent of people who have a hip fracture will have another hip fracture within two years. Bisphosphonates may help reduce the risk of a second hip fracture.

Most of these drugs are taken orally and are associated with side effects that may be difficult to tolerate, including acid reflux and inflammation of the esophagus. To avoid these side effects, your doctor may recommend taking bisphosphonate via intravenous (IV) tubing.

Bisphosphonates generally aren't recommended for people with kidney problems. Rarely, long-term bisphosphonate therapy might cause pain and swelling in the jaw, vision problems or atypical hip fracture.

March 11, 2015

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