Broken Hip Recovery

Broken hip recovery can take a full year. During that time, pain from a hip fracture usually lessens after four to six weeks. It can take 12 weeks for the bone to fully mend. And by six months, some people are able to get close to their pre-injury activity level.

That said, this will vary from person to person, and some people never regain full functioning.

Physical therapy can help to restore mobility, strength, and balance, but often to varying degrees. A hip fracture can cause a steep decline in functioning in older people, for example.

This article discusses the hip fracture recovery process. It also explains treatment options for a broken hip, including surgery, and what to expect during recovery.

Treatment of a Broken Hip

Almost all people who break their hip will require surgery to fix the problem. Different treatment options depend on the fractured bone's location and the injured patient.

The options are to repair the broken bone or replace all or part of the hip joint. The type of surgery will depend on the break. Most fractures have a preferred method of treatment. In some situations, more than one treatment option may be available.

Sometimes families will consider nonsurgical treatment for these injuries. While that may be an option for very frail or very sick patients, it is typically not a good option.

Nonsurgical treatment is only considered for very specific fracture types, such as if the break is only on the pelvis side of the hip joint (and not the femur), then nonsurgical treatment may be possible. But most all hip fractures of the femur bone will require surgery.

Factors to Consider

The problem with the nonsurgical treatment of most types of broken hips is that moving the patient is very difficult because of the pain. There are several problems with not being able to move a person who has been injured:

• It may cause more problems. Immobile people are prone to developing pneumonia, blood clots, and pressure ulcers. These conditions are already issues for older people, and if you can't move someone, the chance of developing one of these problems goes up significantly. For these reasons, repair of a hip fracture is typically recommended even in very frail or very sick patients.
• It can be difficult to care for people. Taking care of someone who can't move is very challenging. Simple tasks such as bathing and toileting someone who cannot move is difficult. While managing the painful symptoms of a broken hip can be accomplished by having someone lie still, it is not reasonable to care for someone without moving them. Therefore, even when broken hips occur in people who are entirely dependent on others for support, they are typically repaired surgically to allow for this care to take place.

Surgery for Hip Fractures

The surgical procedure used to repair a broken hip may vary depending on a number of factors. In general, fractures of the very top of the thigh bone, called the femoral neck, are treated with replacement.

If the femoral neck fracture is not at all displaced (out of position), then a repair of the break may be considered. Fractures below the neck of the femur—known as intertrochanteric or peritrochanteric fractures—are treated with surgical repair using rods, plates, or screws.

The ideal way to fix a particular fracture may vary depending on the fracture pattern, surgeon preference, and the particular patient being treated.

Optimal Recovery From Hip Fractures

The best way to recover from a hip fracture is to get moving as soon as possible. Immobility opens the door to the possibility of significant complications.

For the reasons listed above (preventing pneumonia, blood clot, bedsores, etc.), it is critical to get patients up and moving as soon as possible after surgery. There are a number of ways to help accomplish this goal.

Most importantly, the surgery should be performed soon after the injury. There is controversy about how soon the surgery should be performed, but ideally within 48 hours of the injury, and possibly sooner.

Many hospitals are getting better equipped at getting these individuals with broken hips to an operating room on either the day of or the day after their injury.

There are situations where surgery has to be delayed, such as when there are other major medical issues that need to be addressed prior to a surgical procedure.

Another common situation is when an individual on blood-thinning medication breaks their hip. The blood-thinning effects may need to be reversed prior to safely performing surgery.

The second step is to quickly get up and moving after the surgery. In the hours and days after surgery, the nursing staff and therapists will be working to get people up and moving. Even changing position and sitting up in a chair can help to prevent some of the complications that can occur in people with broken hips.

Chances of Broken Hip Recovery

Unfortunately, full recovery after a broken hip occurs in only about half of all people. The other half will have a decline in function when compared to their pre-injury activity level.

Sadly, almost one-quarter of people who break a hip don't live for a full year after their injury. While this group tends to represent the frailest people who break a hip, it is a startlingly large number.

Regaining mobility, strength, and balance affects one's ability to return to full functioning.

Mobility

In order for joints to function properly, they need to move. A joint that is frozen in space may have good muscle tissue surrounding the joint, but without proper movement, those muscles cannot function properly.

Mobility can be impaired by fracture healing, deformity, implanted hardware, and scar tissue formation.

Strength

Restoration of muscle strength is critical after breaking one's hip. Unlike a hip replacement surgery recovery, where the muscle damage is minimal, the trauma of breaking a hip bone also damages muscle function significantly.

In order to regain muscle function, it is critical to get the muscles working as soon as possible after surgery to prevent potentially permanent atrophy of the muscle tissue.

Balance

Recovery of balance is critical not only to regain function but also to prevent the potential for further injury. Balance is critical to activity, and a decline in function is often the result of a loss of balance.

The use of ambulatory aids (canes or walkers) can be helpful, but regaining proprioception and balance can help restore activity.

Broken Hip Recovery Time

Full healing of a broken hip can take many months. Most fractures take 10 to 12 weeks for healing, and the muscle strength and mobility can take much longer. Typically, people get close to their full recovery within 6 months of the injury, but it can take up to a full year to achieve as much improvement as possible.

That said, people who sustain a hip fracture should not wait for months or longer to be aggressive with their therapy. As time passes, the likelihood of regaining function steadily declines—the strongest gains are made early in the recovery process. 

On a positive note, many people who sustained a hip fracture do recover their pre-injury level of activity and are able to return to their normal activities. Unfortunately, not everyone is able to make that type of recovery.

Most people think of aging as a steady, gradual decline in function. The reality is that as people age, they much more commonly experience long periods of steady functional activity, with intermittent sharp declines in function. A hip fracture can be an event that initiates a sharp decline.