Hip Fractures and Trauma

Fractures of the hip joint commonly involve a break in the upper portion of the thigh bone (femur), where it attaches to the ball of the hip joint. This region is known as the ‘proximal femur’ or ‘femoral neck’.

Hip fractures commonly occur in patients with osteoporosis which is a condition where bones are thinner and less dense than normal). In patients with osteoporosis, fractures can occur after relatively minor trauma or simple falls.

Patients with normal bone strength can sustain hip fractures after more severe injury (e.g. motor vehicle accidents) – in this situation hip dislocations, socket fractures, pelvic injury or other injuries unrelated to the hip may also be sustained.

Osteoporosis is a gradual weakening of the bone with a reduction in bone density, leading to an increased risk of fractures. Osteoporosis causes no symptoms and develops over many years. e risk of developing osteoporosis increases with age & after menopause. It is seen in men and women.

Medical treatment for osteoporosis is most effective if started before there is severe reduction in bone density. For this reason, patients over the age of 50 with a fracture should have their bone mineral density (BMD) measured by DEXA scan.

Surgery is usually recommended. Full recovery of mobility may take some time. One option is internal fixation of the fracture. This involves placing the broken bones back into correct alignment and holding this position with a combination of metal devices such as plates, screws & rods. The metal devices hold the fracture fragments until the bone unites (heals).

Some fractures are not amenable to internal fixation and require joint replacement as treatment for the fracture. Joint replacements used in hip fracture treatment may be ‘half’ hip replacements (where only the broken ball is replaced) or Total Hip Replacements (where both the broken ball and socket are replaced). Which joint replacement is recommended depends on a number of factors (eg. age, fitness, activity level, pre-existing arthritis), and will be decided after clinical assessment.