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Hip fracture

A hip fracture is a serious injury, particularly if you're older, and complications can be life-threatening. Most hip fractures occur in people older than 65, with the risk increasing most rapidly after age 80.

Older people are at higher risk of hip fracture because bones tend to weaken with age. This bone weakening is called osteoporosis. Multiple medications, poor vision and balance problems also make older people more likely to trip and fall — one of the most common causes of hip fracture.

A hip fracture almost always requires surgical repair or replacement, followed by months of physical therapy. Taking steps to maintain bone density and prevent falls can help prevent hip fracture.

Symptoms Causes Risk factors Complications Prevention

Signs and symptoms of a hip fracture may include:

  • Inability to move immediately after a fall
  • Severe pain in your hip or groin
  • Inability to put weight on your leg on the side of your injured hip
  • Stiffness, bruising and swelling in and around your hip area
  • Shorter leg on the side of your injured hip
  • Turning outward of your leg on the side of your injured hip

A severe impact — in a car crash, for example — can cause hip fractures in people of all ages. In older adults, a hip fracture is most often a result of a fall from a standing height. In people with very weak bones, a hip fracture can occur simply by standing on the leg and twisting.

A combination of factors may increase your risk of a hip fracture, including:

  • Age. The rate of hip fractures increases substantially with age. As you age, your bone density and muscle mass both decrease. Older age may also bring vision and balance problems, along with slower reaction time to avoid falling when you feel unsteady. If you're inactive, your muscles tend to weaken even more as you age. All of these factors combined can increase your risk of a hip fracture.
  • Your sex. Women lose bone density at a faster rate than men do. The drop in estrogen levels that occurs with menopause accelerates bone loss, increasing the risk of hip fractures. However, men also can develop dangerously low levels of bone density.
  • Chronic medical conditions. Osteoporosis is the most powerful risk factor for hip fracture, but other medical conditions may lead to fragile bones. These include endocrine disorders, such as an overactive thyroid, and intestinal disorders, which may reduce your absorption of vitamin D and calcium.
  • Certain medications. Cortisone medications, such as prednisone, can weaken bone if you take them long term. In some cases, certain drugs or the combination of medications can make you dizzy and more prone to falling.
  • Nutritional problems. Lack of calcium and vitamin D in your diet when you're young lowers your peak bone mass and increases your risk of fracture later in life. Serious eating disorders, such as anorexia nervosa and bulimia, can damage your skeleton by depriving your body of essential nutrients needed for bone building.
  • Physical inactivity. Weight-bearing exercises, such as walking, help strengthen bones and muscles, making falls and fractures less likely. If you don't regularly participate in weight-bearing exercise, you may have lower bone density and weaker bones.
  • Tobacco and alcohol use. Smoking and drinking alcohol can interfere with the normal processes of bone building and remodeling, resulting in bone loss.

A hip fracture is a serious injury that can reduce your future independence and sometimes even shorten your life. Many adults who lived independently prior to their hip fracture are still in a nursing home more than a year after their injury.

If a hip fracture keeps you immobile for a long time, you may develop one or more of the following complications:

  • Blood clots in your legs or lungs
  • Bedsores
  • Urinary tract infection
  • Pneumonia

Additionally, people who've had one hip fracture have a significantly increased risk of having another one.

Healthy lifestyle choices in early adulthood build a higher peak bone mass and reduce your risk of osteoporosis in later years. The same measures may lower your risk of falls and improve your overall health if you adopt them at any age. Tips include:

  • Exercise to strengthen bones and improve balance. Weight-bearing exercises, such as walking, encourage your body to increase bone density. Exercise also increases your overall strength, making you less likely to fall. Try to exercise for 30 minutes a day on most days of the week. Balance training is also key to reducing your risk of falls, since balance tends to deteriorate with age.
  • Don't drink excessively or smoke. Preserve your bone density by avoiding the excessive use of alcohol and by not smoking. Drinking too much alcohol also can impair your balance and make you more likely to fall.
  • Assess your home for fall hazards. Remove throw rugs, keep electrical cords against the wall, and clear excess furniture and anything else that could trip you. Make sure every room and passageway is well lit.
  • Check you eyes. Go to your eye doctor for an exam every other year, or more often if you have diabetes or an eye disease.
  • Watch your medications. Feeling weak and dizzy, which are possible side effects of many medications, can increase your risk of falling. Talk to your doctor about side effects caused by your medications.
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