Types of hip fractures
Most hip fractures occur in one of two locations — at the femoral neck or in the intertrochanteric region. The location of the fracture helps determine the best treatment options.
Often your doctor can determine that you have a hip fracture based on your symptoms and the abnormal position of your hip and leg. An X-ray usually will confirm that you have a fracture and show where the fracture is.
If your X-ray doesn't show a fracture but you still have hip pain, your doctor might order an MRI or bone scan to look for a hairline fracture.
Most hip fractures occur in one of two locations on the long bone that extends from your pelvis to your knee (femur):
- The femoral neck. This area is situated in the upper portion of your femur, just below the ball part (femoral head) of the ball-and-socket joint.
- The intertrochanteric region. This region is a little farther down from the hip joint, in the portion of your upper femur that juts outward.
A hip fracture can be repaired with the help of metal screws, plates and rods. In some cases, artificial replacements (prostheses) of parts of the hip joint may be necessary.
Treatment for hip fracture usually involves a combination of surgery, rehabilitation and medication.
The type of surgery you have generally depends on the where and how severe the fracture is, whether the broken bones aren't properly aligned (displaced), 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.
- Total hip replacement. Your upper femur and the socket in your pelvic bone are replaced with artificial parts (prostheses). Increasingly, studies show total hip replacement to be more cost-effective and associated with better long-term outcomes in otherwise healthy adults who live independently.
- Partial hip replacement. If the ends of the broken bone are displaced or damaged, your surgeon might remove the head and neck of the femur and install a metal replacement. Partial hip replacement might be recommended for adults who have other health conditions or cognitive impairment or who no longer live independently.
Your doctor might 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.
Your care team will likely 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 help at home, you might need to go from the hospital to an extended care facility.
In extended care and at home, you might 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 might help you regain mobility and independence.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.
Preparing for your appointment
You may be referred to an orthopedic surgeon.
What to expect
Your doctor might ask:
- Have you recently fallen or had another injury to your hip?
- How severe is your pain?
- Can you put weight on your leg on the side of your injured hip?
- Have you had a bone density test?
- Have you been diagnosed with any other medical conditions? What medications are you currently taking, including vitamins and supplements?
- Do you use alcohol or tobacco?
- Have you ever had surgery? Were there any problems?
- Do any of your blood relatives — such as a parent or sibling — have a history of bone fractures or osteoporosis?
- Do you live independently?