Hip Fracture Types and Complications

A hip fracture, also called a broken hip, is a common injury. In the United States, hip fractures are the most common broken bone that requires hospitalization; about 300,000 Americans are hospitalized for a hip fracture every year.

Older adults who have osteoporosis are at an especially high risk of hip fractures. Hip fractures cause pain and decreased mobility, and they can also lead to complications, including infections and blood clots. Prompt treatment can minimize these issues.

Xray of a broken hip
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In younger people with stronger bones, hip fractures are usually caused by high-energy injuries such as car accidents or falls from a height.

While a fall can cause a hip fracture, most hip fractures are actually due to fragile bone that breaks, which then causes the person to fall. A broken hip can also occur due to a pathologic fracture, which is a fracture that occurs in a weak portion of a bone, which can occur due to a tumor or infection.

Hip Fractures and Osteoporosis

Hip fractures in older people are most frequently caused by osteoporosis, a condition in which the bones become thin, fragile, and lose bone mass.

With thinner, weaker bones, people who have osteoporosis are at a much greater risk of developing a hip fracture from accidents such as falls. And they can also develop broken bones without a major injury—which could lead to a major fall and a hip fracture.

Seniors who have osteoporosis are at a much higher risk of developing a hip fracture than those of the same age who don't have osteoporosis. Women, white people, smaller sized adults, and those who have limited physical activity have slightly higher rates of hip fracture as well.

Types

There are several types of hip fractures:

  • Femoral Neck FracturesA femoral neck fracture occurs when the ball of the ball-and-socket hip joint is fractured off the top of the femur (thigh bone). Treatment of a femoral neck fracture depends on your age and whether the ball has been displaced.
  • Intertrochanteric Hip Fractures: An intertrochanteric hip fracture occurs just below the femoral neck. These fractures are repaired more often than femoral neck fractures. The usual surgical treatment involves the placement of a plate or a rod and screws to stabilize the bones as they are healing.
  • Pelvic fractures: Some types of bone fractures near the hip joint are also often referred to as broken hip.
  • Pelvic insufficiency fractures: These fractures occur in the pelvic bone, not the femur, and typically are treated without surgery.
  • Acetabular fracture: This is an injury to the hip socket. Although some of these injuries may be treated nonsurgically, more invasive treatment is sometimes necessary because they also involve the hip joint.

Treatment of a hip fracture almost always requires surgery. The type of surgery will depend on the type of fracture.

In some cases, such as with certain stress fractures of the hip, or in people who have severe medical problems that prevent surgical treatment, nonoperative treatment may be recommended.

Complications

Only about 25% of people who sustain a broken hip return to their preinjury level of activity. Focused rehabilitation and strengthening are the best treatments to get you back to your preinjury level of activity after a hip fracture.

One of the most important reasons for surgery after a hip fracture is to help prevent complications. The risk of complications such as pneumonia, bedsores, and blood clots are diminished the sooner you are up and out of bed after a hip fracture surgery.

The mortality (death) rate in the first year following a broken hip is significantly increased, and the rates are highest in older populations. Mortality following a hip fracture is often due to blood clots, pneumonia, or infection.

The majority of people who sustain a hip fracture will require prolonged specialized care during recovery, such as a long-term nursing or rehabilitation facility. After recovery, you may be at a higher risk of breaking your hip again, so it's important to be thorough in your recovery plan.

A Word From Verywell

You can recover after a hip fracture and regain some or all of your mobility. It is not uncommon for people to break their other hip or sustain other serious injuries resulting from a weakened bone after an initial hip fracture.

If you or a loved one has already sustained a broken hip, preventing future fractures is especially important. Getting treatment for your osteoporosis and participating in physical therapy to improve your strength and balance can help prevent future fractures.

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Article Sources
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  1. Centers for Disease Control and Prevention. Hip fractures among older adults. Updated September 20, 2016.

  2. American Academy of Orthopaedic Surgeons. Acetabular fractures. Updated February 2016.

  3. Katsoulis M, Benetou V, Karapetyan T, et al. Excess mortality after hip fracture in elderly persons from Europe and the USA: the CHANCES project. J Intern Med. 2017;281(3):300-310. doi:10.1111/joim.12586

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