Geriatric Femoral Neck Fractures (Broken Hip in Older People)

Physical Therapy Videos - Hip and Pelvis

What Is It?

The human hip joint is like a ball and socket. The top part of the thigh bone (femur) is the ball, and it fits into the hip socket. The thigh bone has a part called the femoral neck that connects the ball to the long part of the bone. The hip has big muscles around it that help you move your leg. The blood vessels and nerves for your hip and leg are in the front and back.

The image on the left is an x-ray of an adult hip, on the right the femoral neck — Figure 1: The left is an x-ray of an adult hip. In the image on the right, the femoral neck (red), femoral head (yellow) and hip socket (blue) are outlined.

Figure 2: A model of the pelvis and hips.

How It Happens

Broken hips are common in people over 65 because bones get weaker as we age. These breaks usually happen when someone falls on their hip. Broken hips can also happen from car accidents or jumping off something like a ladder.

X-rays of a displaced femoral neck fracture — Figure 3: X-ray showing a broken hip.

First Steps

Broken hips hurt a lot and make it hard or impossible to walk. People with broken hips usually go to the emergency room. At the hospital, doctors take X-rays and give pain medicine. Most broken hips need surgery and a stay in the hospital. Before surgery, doctors check your health and may do more tests.

Treatment

Surgery is the main way to treat a broken hip. Doctors can fix the break with screws, a plate, or replace part or all of the hip joint. Some broken hips need a partial or total hip replacement. Your surgeon will talk to you about which option is best for you. Surgery usually happens within 48 hours of the injury. If you are too sick, surgery may need to be delayed longer.

Postoperative x-ray of a patient with a displaced femoral neck fracture treated with a total hip replacement — Figure 4: X-ray of a patient with a femoral neck fracture who was treated with a total hip replacement.

ostoperative x-ray of a patient with a displaced femoral neck fracture treated with a partial hip replacement — Figure 5: X-ray of a patient with a displaced femoral neck fracture treated with a partial hip replacement.

Postoperative x-ray of a patient with a non-displaced femoral neck fracture treated with screws — Figure 6:X-ray of a patient with a non-displaced femoral neck fracture treated with screws.

Recovery

After surgery, patients do physical therapy to get stronger and walk normally again. It's important to get moving as soon as possible to avoid problems like bed sores, blood clots, and pneumonia. You may need to go to a rehab center before going home. Always follow your surgeon's instructions.

Long Term

After surgery, patients might need a walker or cane for a while. It's important to prevent future falls and talk to your doctor about your bone health. Problems like blood clots, infections, and limping can happen, but they're not common. Some patients might need more surgery for certain complications or if the bone doesn’t heal.