Hip Fracture
A neck of femur fracture (also called a hip fracture) Is a break in the upper part of the thigh bone (femur) just below the ball of the hip joint. This injury is most common in older adults after a fall, but can also occur in younger people after high-impact trauma, or as stress fractures from repetitive minor trauma.
Anatomy
The femoral neck connects the femoral head (the ball part of the hip joint) to the shaft of the thigh bone. It carries body weight through the hip joint and is supplied by delicate blood vessels that are important for bone healing.
Hip Fracture
Symptoms
Common symptoms include:
- Severe pain in the groin or hip
- Inability to stand or walk
- The leg may appear shortened or turned outward
- Swelling or bruising around the hip.
Diagnosis
Your doctor will assess your hip and take X-rays to confirm the fracture. Sometimes a CT or MRI scan is needed to detect subtle or incomplete fractures.
Treatment
Treatment depends on the location and stability of the fracture, as well as the patient’s age and activity level:
- Some incomplete stress fractures can be managed without surgery - but require strict weight-bearing restrictions and close follow up.
- Investigations for bone mineral density or endocrine disorders will be undertaken.
- Investigations for bone mineral density or endocrine disorders will be undertaken.
- Undisplaced complete fractures (where the bone remains aligned) may be treated with surgical fixation, using screws or a small plate to hold the bone together.
- Displaced fractures (where the bone ends have shifted) usually require hip replacement surgery — either a partial (hemiarthroplasty) or total hip replacement, depending on the patient’s condition and bone health.
- Extra-articular hip fractures that do not compromise the blood supply to the femoral head are often managed with an intramedullary nail (inside the bone), performed percutaneously (through small cuts) using intra-operative imaging (x-ray).
Recovery
Most patients begin gentle movement soon after surgery with the help of physiotherapists. Full recovery can take several months, and rehabilitation is focused on regaining mobility, balance, and independence. For young patients having fixation the follow up continues for at least 2 years to ensure the blood supply to the femoral head has remained competent.
Possible Complications
While most people do well after surgery, potential complications include:
- Difficulty walking or stiffness
- Shortening of the leg
- Hip dislocation (in replacement cases)
- Blood clots, infection, or wound problems
- Avascular necrosis (loss of blood supply to the femoral head in some fracture types) - may necessitate further surgery or a total hip replacement.
Avascular Necrosis of the Hip (AVN)
When to Seek Help
Seek urgent medical care if you have:
- Severe hip or groin pain after a fall
- Inability to walk or bear weight
- A leg that looks shortened or turned outward.
