Orthopaedic Conditons & Treatments

Hip Fracture, Symptoms and Causes

A hip fracture is the complete or partial breakage of the upper thighbone, known as the proximal femur. The femur’s rounded end (known as its head) sits tightly but freely in the pelvis’ socket. The correct functioning of this “ball and socket” joint is essential for human locomotion. Hip fractures can cause loss of the ability to stand and walk because of the tendency of the bone to heal in a malformed way – the result of stress the thigh’s musculature exerts on the bone. Every year, 300,000 Americans find themselves in hospital beds because of hip fractures.

While the injury is much more prevalent in the elderly population (because of osteoporosis), younger people have in the past 20 years been breaking their hips in increasing numbers. Women are more susceptible to hip fracture than men. According to the John Hopkins School of Hygiene and Public Health, 16% of white women suffer hip fractures, while only 5% of white men do. (Because they suffer from osteoporosis in greater numbers, whites and Asians are more susceptible to hip fractures than are blacks and Hispanics.) Without proper medical intervention and care, hip fractures can be permanently debilitating or fatal. They can lead to blood clots, urinary tract infections and pneumonia.

Anatomy of the Hip

The hip is the joint where the thighbone and the pelvic bone meet. It consists of the following:

  • The hip bones (two flat bones that contain the “socket” portion of the “ball-and-socket” hip joints)
  • The acetabulum (the socket)
  • The femoral head (the ball)
  • The femur (the thigh bone)
  • The articular capsule (connective tissue)

The hip is one of the most resilient structures in the body. But because of the stress put on it by having to bear dynamic body weight (and, in older people, the loss of bone mass – osteoporosis) for many years, it eventually loses resiliency. The hips are in the region of the body known as the lower trunk. When the body’s lower trunk becomes compromised, many essential activities become difficult to perform.

Types of Hip Fracture

Hip fractures can be divided into three main types of injury:

  • Femoral-neck fracture – The femoral neck is under the femoral head and 1-2 inches from the joint it makes with the acetabulum. Older people commonly get femoral-neck fractures because this already relatively thin portion of the femur has been further attenuated by osteoporosis. Because a fracture of the femoral neck frequently keeps blood from flowing to the femoral head (and thus the hip joint), complications such as blood clots in the legs may result from this type of hip fracture. 
     
  • Intertrochanteric hip fracture – This type of fracture occurs below the femoral neck, between the greater and lesser trochanter. As an intertrochanteric hip fracture will not affect blood flow, it tends to be easier to repair (that is, it tends to present fewer complications) than a femoral-neck fracture.
     
  • Stress fracture – Stress fractures, which only make up about 10% of total hip fractures, can be harder to diagnose than the other two types. The sufferer of a stress fracture may mistake the condition for tendinitis or normal muscle soreness. This hairline fracture, which affects mostly members of the military and athletes, is caused by overexertion and repetitive motion. 

Causes of Hip Fracture

There are many causes of hip fracture. Some causes are associated mainly with older people, some are associated mainly with younger people and some with people of all ages:

  • Intense impacts – The sort of traumatic impact sustained in an automobile accident or a fall from a great height can cause hip fractures in people of any age.
     
  • Contact-sports injuries – Players of football (American and European) and rugby have been known to suffer hip fractures because of falls taken with the legs in unnatural positions (frequently with fellow-players on top of them). When legs are twisted unnaturally and pressure is applied to them, there is the potential for a cracked femur.

  • Overly demanding training regimens – While hip fractures from training injuries used to be mostly limited to military personnel, in the last twenty years – as extreme physical training has become more popular – more and more civilians have been sustaining stress fractures from overexertion during physical training.

  • Falls from a normal height – Elderly people, because of bad vision, compromised balance and the side effects of medications, fall more than young people do. They may fall walking on level ground or even when standing still. Because people’s bones lose the calcium and other minerals that give them strength as the years go by, people over 60 suffer 90% of all hip fractures.

Symptoms of Hip Fracture

Different types of hip fractures have different symptoms. But, generally speaking, if you have broken your hip, you will feel intense pain in your hip and groin. You will have a loss of mobility in your leg. It will bruise and swell, and it will feel stiff. Additionally, you will not be able to use the affected leg to support your own weight.  

The following are common hip fracture symptoms. Keep in mind that everyone’s body is different and will react somewhat differently to trauma:

  • Hip pain
  • Knee pain
  • Lower back pain
  • Bruised leg
  • Swollen leg
  • Twisted foot (a condition that makes the leg appear shorter)

Hip-fracture symptoms may be mistaken for the symptoms of other medical conditions (a herniated intervertebral disc, spinal stenosis, a sprain, tendinitis, etc.).  Make sure you consult a doctor in order to determine if you have a hip fracture and get the appropriate treatment.  

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Trauma Services in New York treats Hip Fractures as well as a broad range of conditions that affect the bones within the body.

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