The rounded top of the thighbone, or femur, fits into a concave socket in the pelvis at the hip bone, allowing for full range of movement. A hip fracture occurs when some part of the upper portion of the thighbone breaks, causing pain and impairing a person's ability to flex or rotate the upper thigh. To treat the fracture, doctors must stabilize, rebuild or replace the broken bone and protect the hip from further injury during the healing process.
Surgery
Hip fractures often require surgery to stabilize the hip bones and restore strength and motion to the joint. The type of surgery varies depending upon the location and severity of the fracture, as well as the patient's overall health and pre-injury activity level.
For femoral neck fractures--those occurring in the area of bone that connects the head with the body, or shaft, of the thighbone--surgeons may insert metal screws and/or nails to stabilize the broken bones while they heal, according to Merck Manual.
If either the ball-like head of the femur or the socket joint in the pelvis is damaged or misaligned, a doctor may instead perform a partial hip replacement, or hemiarthroplasty--a procedure in which half of the joint is replaced with a synthetic prosthesis. If both the head of the femur and the socket in the pelvis are damaged, the surgeon may treat the injury with a total hip replacement--a surgical procedure in which the entire ball-and-socket joint is replaced with metal prostheses.
According to MayoClinic.com, surgeons typically treat intertrochanteric fractures--those occurring below the femoral neck--by inserting compression screws across the fracture and attaching them to a plate that runs vertically down the thighbone.
Casting
Children who have undergone surgery for a hip fracture are sometimes advised to wear a hip spica cast--a body cast made of fiberglass that protects the hip from further injury. According to Seattle Children's Hospital, most children wear the cast for four to six weeks after surgery in order to facilitate healing of the hip joint.
Rehabilitation
After surgery, patients typically undergo rehabilitation with a physical and occupational therapist who help them to regain their independence in performing everyday activities such as bathing, dressing and using the bathroom. According to MayoClinic.com, most patients remain in the hospital for up to a week after surgery. During that time, they may begin light exercises to improve hip strength, flexibility and range of motion, sometimes using a walker to help themselves move around. After leaving the hospital, most people continue to work on their own at home and with their assigned therapist for a month or more, depending upon their progress.
Medication
People who fracture their hips once are at higher risk for suffering another hip fracture in the future. To strengthen the bones and help to prevent second fractures, some patients are treated with prescription bisphosphonates--drugs that help to increase bone density by preventing the release of calcium from the bones. According to MayoClinic.com, oral bisphosphonates can cause bothersome side effects, so some patients may respond better to an intravenous form called zoledronic acid administered only once per year.
