What is a hip fracture?

A hip fracture is a break in the femur (thigh bone) of the hip joint. Joints are areas where two or more bones meet. The hip joint is a "ball and socket" joint where the femur meets the pelvic bone. The ball part of the hip joint is the head of the femur, and the socket is a cup-like structure in the pelvic bone called the acetabulum. Hip fracture is a serious injury and requires immediate medical attention.

What are the different types of hip fracture?

A fracture is a partial or complete break in a bone. There can be either a single break or multiple breaks in a bone. A hip fracture is classified by the specific area of the break and the type of break(s) in the bone.

The most common types of hip fractures are:

  • Femoral neck fracture. A femoral neck fracture occurs one to two inches from the hip joint. These  fractures are common among  older adults and can be related to osteoporosis. This  type of fracture may cause a complication because the break usually cuts off the  blood supply to the head of the femur which forms the hip joint.  

  • Intertrochanteric hip fracture. An intertrochanteric hip fracture occurs three to four inches from the hip joint. This type of fracture does not interrupt the blood supply to the bone and may be easier to repair.

Around 90 percent of hip fractures fall into these two categories in relatively equal numbers. Another type of fracture called a stress fracture of the hip may be harder to diagnose. This is a hairline crack in the femur that may not involve the whole bone. Overuse and repetitive motion can cause a stress fracture. The symptoms of this injury may mimic those of tendonitis or muscle strain.

Who is affected by a hip fracture?

About 90 percent of hip fractures happen to people over age 60. The incidence of hip fractures increases with age, doubling for each decade after age 50. Caucasians and Asians are more likely to be affected than others primarily because of a higher rate of osteoporosis. Osteoporosis (loss of bone tissue) is a disease that weakens bones.

Women are more prone to osteoporosis than men; therefore, hip fracture is more common among women. They experience about 80 percent of all hip fractures. More than 1.5 million Americans have fractures annually because of osteoporosis.

The number of hip fractures in the US is the highest in the world with approximately 300,000 occurrences each year. In 2003, there were about 309,500 hospitalizations for hip fractures. It is estimated that the number could exceed 500,000 by the year 2040.

Why is a hip fracture so serious?

People who sustain a hip fracture are more likely to die than a person of the same age who does not experience this injury. About 20 percent of people who have a hip fracture die within a year of their injury. It is estimated that only one in four persons have a total recovery from a hip fracture.

Most people spend from one to two weeks in the hospital after a hip fracture. The recovery period may be lengthy, and may include admission to a rehabilitation facility. People who previously were able to live independently will generally need help from home caregivers, family, or may require the services of a long-term care facility. Hip fractures can result in a loss of independence, reduced quality of life, and depression, especially in older people.

What causes a hip fracture?

A fall is the most common reason for a hip fracture among the elderly. A small percentage of people may have a hip fracture occur spontaneously. In younger people, a hip fracture is generally the result of a car accident, a fall from a great height, or severe trauma.

Hip fracture is more common in older people because bones become thinner and weaker from calcium loss as a person ages, generally due to osteoporosis. Bones affected by osteoporosis are more likely to break if a person falls. Most hip fractures sustained by older people occur as a result of falling while walking on a level surface, often at home.

As they get older, women lose 30 percent to 50 percent of their bone density (thickness). The loss of bone speeds up dramatically after menopause because women produce less estrogen. Estrogen contributes to maintaining bone density and strength.

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