A hip fracture is a break in the thighbone just below the hip joint. The hip joint consists of a ball at the top of the thighbone (femur) and a rounded socket (acetabulum) in the pelvis. Most hip fractures occur in the femur one to two inches below the ball portion of the hip.

Causes

Factors that may contribute to a hip fracture include:

• Falls, the most frequent cause of hip fractures

• Osteoporosis--a bone-thinning disease that weakens all bones including the hip

• Motor vehicle accidents and other types of major trauma

• Stress fractures in athletes (rare)

• Bone diseases such as osteomalacia (rare)

• Bone tumors (rare)

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Previous hip fracture or history of falling

• Age: 65 years or older

• Sex: Female (especially after menopause)

• Heredity

• • Family history of fractures later in life

• • Small-boned, slender body (low body weight)

• • Caucasian or Asian race

• Others:

• • Poor nutrition

• • Deficient intake or absorption of calcium and vitamin

• • Low body weight

• • Physical inactivity

• • Weakness

• • Poor balance and coordination

• • Smoking

• • Excessive alcohol use

• • Chronic disease or fragile health

• • Irregular heart beat or low blood pressure

• • Arthritis

• • Parkinson's disease

• • History of stroke

• • Mental impairments including Alzheimer’s Disease

• • Problems with vision

• • Certain medications which cause dizziness, drowsiness, or weakness

• • Systemic cortisone or other steroids

• • Excess thyroid hormone

Symptoms

Symptoms may include:

• Pain in the hip

• Difficulty or inability to stand, walk or move the hip

• Abnormal appearance of the broken leg:

• • Looks shorter

• • Turns outward

Diagnosis

The doctor will ask about your symptoms, how the injury occurred, and then will perform a physical exam.

Tests may include:

X-Ray–to determine exactly where the bone is broken and how far out of place the pieces have moved

Bone Scan or MRI Scan–used if the fracture doesn't show up on x-rays but symptoms indicate a fracture has occurred

Treatment

The goal is to get you back on your feet again as quickly as possible while your broken bone heals.

Treatment includes:

Prevention

Early corrective action may help alleviate many of the factors that can lead to a hip fracture. Here's what you can do:

• Eat a diet with nutrients for strong bones:

• • Calcium–about 1000 milligrams daily, but check with your doctor

• • Vitamin D–400-800 units a day

• • Adequate protein intake

• Exercise:

• • Ask your doctor before starting.

• • Weight-bearing activities such as walking

• • Strengthening exercises for both upper and lower extremities

• See your doctor if you are at risk for osteoporosis. Preventive medication may include:

• • Hormone replacement therapy for women after menopause

• • Biphosphonates

• • Calcitonin

• Ask your provider if any of your medications may contribute to:

• • Bone loss

• • Dizziness, drowsiness, or confusion

• Reduce falling hazards at work and home:

• • Clean spills and slippery areas immediately.

• • Remove tripping hazards such as loose cords, rugs and clutter.

• • Use non-slip mats in the bathtub and shower.

• • Install grab bars next to the toilet and in the shower or tub.

• • Put in handrails on both sides of stairways.

• • Walk only in well-lighted rooms, stairs, and halls.

• • Keep flashlights on hand in case of a power outage.

• Get your eyes checked regularly.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

Mayoclinic.com
http://www.mayoclinic.com

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org. Accessed October 12, 2005.

Feskanich D, Willett W, Colditz G. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA. 2002 Nov 13;288(18):2300-6.

Hip fracture. DynaMed website. Available at: http://www.dynamicmedical.com/. Accessed October 12, 2005.

Hip fractures. E-medicine website. Available at: http://www.emedicine.com/. Accessed February 2001.

National Center for Injury Prevention and Control website. Available at: http://www.cdc.gov/ncipc/default.htm. Accessed October 12, 2005.