Hip Fracture (Broken Hip)

A fractured hip is an orthopedic emergency and requires immediate treatment. Do not drive yourself or a loved one to the emergency room after a suspected broken hip — call 9-1-1 for transportation that can provide life-saving care en route to the hospital.

What is a Hip Fracture?

What we commonly refer to as a broken hip or hip fracture is typically not a break in the pelvis or hip bone itself. Instead, it is most often a fracture of the upper femur — thigh bone — just before it sockets into the hip joint.

Why Is Breaking a Hip so Serious?
Hip fractures are especially serious for older adults, and the probability of sustaining a fractured hip doubles each decade after a person turns 50. Adults aged 65+ are the most common victims of hip fractures, as they have thinner bone density and less muscle strength. Those at the highest risk for breaking a hip are older adults, especially women, as they lose 30% to 50% of their bone density post-menopause, when women’s bodies produce less estrogen. The estrogen hormone maintains bone density and strength.

Sustaining a hip fracture is dangerous to your overall health, because it not only takes significant time to heal, much of which you’ll be bedridden, but ongoing research since 1980 shows patient mortality outcomes have not significantly improved.

Symptoms of a Fractured Hip?

A broken hip often causes significant discomfort, but the symptoms of a broken hip aren’t always obvious, especially in older adults. They may include:

• Pain in the hip, groin, or upper thigh: The pain is usually severe and localized, but it may also radiate.
• Knee pain on the affected side: The referred pain can mislead people to believe the injury is in the knee.
• Lower back pain: Some patients experience pain that seems to radiate into the lower back or buttock region.
• Inability to stand, walk, or bear weight: Most patients with a fractured hip, rather than a hip stress fracture, cannot stand or walk without extreme pain or instability.
• Stiffness, bruising, or swelling of the hip area: Swelling or discoloration may be visible in the outer hip or upper thigh area.
• Shortened or outward-turned leg: A broken hip may cause the affected leg to appear shorter or rotate outward due to muscle imbalances.

Hip Fracture Types

Not all hip fractures are the same. Some patients experience a single break or multiple breaks of the same bone. The most common hip fracture types are:

• Femoral neck fracture: One of the most common hip fractures, especially among women who have osteoporosis, occurs in the narrow part of the thigh bone, about 1-2 inches from the hip joint. This type of hip fracture may cause complications that cut off the blood supply to the head of the femur, which forms the hip joint.
• Intertrochanteric hip fracture: These hip fractures occur 3-4 inches away from the hip joint, and may be easier to repair, because the fracture typically doesn’t disrupt the blood supply to the injured bone.
• Hip stress fracture: A hip stress fracture is a tiny crack in the femoral neck that develops gradually from repetitive impact or overuse, not a sudden fall. Stress fractures of the hip are more common in athletes, military recruits, or individuals with low bone density. If undiagnosed, they can worsen over time and lead to a full fracture requiring surgery.
• Subtrochanteric hip fracture: This type of hip fracture occurs lower on the upper femur and typically results from high-impact trauma or severe bone weakening. These fractures often require more complex surgical stabilization.

What Causes Hip Fractures?

A hip fracture is usually caused by a fall, especially in older adults with weakened bones. Direct trauma, osteoporosis, or overuse can also lead to a fractured hip or hip stress fracture. High-impact accidents may cause a shattered hip. Weakened bone structure increases the risk of a broken hip.

Diagnosing a Hip Fracture

Your hip surgeon will typically order an X-ray of the hip and femur to properly diagnose a fractured hip. In some cases, a fractured hip cannot be seen on a regular X-ray, and an MRI may be recommended for patients experiencing hip pain. The MRI scan can usually show a hidden or incomplete hip fracture. If a patient is unable to undergo an MRI, a CT scan may be ordered instead. However, a CT scan is not as sensitive as an MRI in seeing hidden hip fractures.

Complications of a Fractured or Broken Hip

Serious complications of a fractured or broken hip can include blood clots, infection of the bone or surrounding tissues, and long-term loss of mobility. In some cases, the bone may heal poorly (malunion), fail to heal (nonunion), or develop avascular necrosis — bone death due to disrupted blood flow to the bone.

Prompt surgery lowers these risks, especially in older adults who are more vulnerable to complications and long-term disability.

When to See a Doctor for a Fractured Hip

If you experience sudden hip pain after a fall, cannot stand or walk, or notice swelling, bruising, or your leg turning outward, seek medical help immediately — a fractured hip is a medical emergency. Even without trauma, persistent groin or thigh pain that worsens with movement could signal a hip stress fracture. Don’t wait as early evaluation can prevent further damage.

If you have been diagnosed with a broken hip or are experiencing symptoms of a fractured hip, contact Hoag Orthopedic Institute. Our fellowship-trained orthopedic hip doctors specialize in treating a broad range of hip conditions with both conservative and surgical hip treatments. Our orthopedic hip surgeons use the most advanced robotic-assisted and arthroscopic surgical techniques to minimize trauma and maximize your healing.

From postural changes and corticosteroid injections for hip bursitis to anterior and total hip replacements, our expert team provides personalized care to get you back on your feet, no matter what hip condition you are experiencing.

If you have a fractured hip please call 9-1-1 immediately for emergency care.

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