A hip fracture is a partial or complete break in the upper portion of the thighbone (femur), the leg bone that forms part of the hip joint. Most hip fractures occur in the neck of the thighbone (the area just below the ball that fits into the hip socket in the pelvis), while the rest occur in the intertrochanteric area (across the outside portion of the upper thighbone).

Age, disease, and gender increase your chances of fracturing a hip. Once you reach age 50, the odds increase significantly and double every five to six years thereafter. Globally, 1.6 million hip fractures occur each year.¹

Bones begin to weaken with age, particularly among women. It's estimated that osteoporosis, the disease that renders bones brittle and easy to break, affects more than 200 million women worldwide. With osteoporosis, your chances of breaking a bone in a fall increase dramatically. Falls are responsible for 90% of all hip fractures.

A woman is two to three times more likely than a man to suffer a fractured hip. And the risk for women 5'8'' or taller is twice that of women who are under 5'2''.²

Immediate surgery is almost always required, but the type of operation may depend on what kind of fracture you have.

If the break is in the neck of the thighbone, the fragmented ends can sometimes be realigned and fastened together with internal fixation. But a fracture across the femoral neck that interrupts the blood supply to the head of the femur can eventually cause avascular necrosis, so some doctors believe a total hip replacement is a better choice.

If the break is in the area across the outside portion of your upper thighbone (the intertrochanteric area), which has a good blood supply, it is usually treated successfully with internal fixation (see below).

Hip-fracture patients with strong bones and a normal supply of blood to the thighbone are good candidates for a repair called internal fixation. In this surgery, the broken ends of the bones are lined up and fastened into place with small metal devices. By realigning the broken pieces of thighbone, the fracture heals faster than it would on its own.

For patients with bones weakened by osteoporosis, a total hip replacement is often considered the treatment of choice.

References

1. Facts and statistics about osteoporosis and its impact [internet]. International Osteoporosis Foundation [updated 2011 Jan; cited 2011 Nov 16]. Available from: http://iofbonehealth.org/facts-and-statistics.html.
2. Falls and Hip Fractures [Internet]. American Academy of Orthopaedic Surgeons; 2007 July [cited 2011 Nov 16]. Available from: http://orthoinfo.aaos.org/topic.cfm?topic=A00121