Hip Fractures
What is a Hip Fracture?
A hip fracture is a break in the upper part of the femur (thigh bone). Hip fractures are a major cause of pain, disability and loss of independence, particularly in the elderly population. They are commonly the result of a low energy fall in patients with osteoporosis, but can also occur after high energy trauma in younger patients.
Hip fractures are classified according to their anatomic location:
• Femoral neck (intracapsular) fractures: occur within the capsule of the hip joint and can disrupt the blood supply to the femoral head, increasing the risk of avascular necrosis and non-union.
• Intertrochanteric fractures: occur between the greater and lesser trochanters, outside the joint capsule.
• Subtrochanteric fractures: occur in the region just below the lesser trochanter.
Symptoms of Hip fractures
Patients who have sustained a hip fracture typically present with:
Treatment options
Almost all hip fractures require surgical treatment to allow early mobilisation and reduce the significant risks of prolonged bed rest. The choice of surgery depends on the type of fracture, the degree of displacement, the patient’s age, activity level and bone quality:
• Cannulated screw fixation for undisplaced femoral neck fractures in younger patients
• Hemiarthroplasty (partial hip replacement) for displaced femoral neck fractures in lower demand elderly patients
• Total hip replacement for displaced femoral neck fractures in active, healthy patients
• Dynamic hip screw or intramedullary nail for intertrochanteric fractures
• Intramedullary nail for subtrochanteric fractures
Comprehensive multidisciplinary care, including early mobilisation, physiotherapy, nutritional support and bone health optimisation, is key to recovery and reducing the risk of further fractures.
Frequently Asked Questions (FAQ)
Hip arthritis usually develops over time rather than from a single cause. The most common reason is gradual wear of the joint cartilage with age. However, many people develop it earlier due to subtle issues with the shape of the hip, when the ball and socket don’t fit perfectly, it creates uneven pressure that slowly damages the joint. Previous injuries, such as fractures or dislocations, can also speed up this process. In some cases, genetics, inflammation, or increased load on the joint (including higher body weight or repetitive stress) contribute.
