Hip fractures

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources

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Last reviewed: 26 Sep 2025
Last updated: 21 Aug 2025

Summary

Definition

History and exam

Key diagnostic factors

  • inability to bear weight
  • pain in affected leg/hip
  • pain with hip movement
Full details

Other diagnostic factors

  • shortened and externally rotated leg
Full details

Risk factors

  • osteoporosis/osteopenia
  • age over 65 years
  • falls
  • low body mass index
  • female sex
  • high-energy trauma
  • medications
  • ethnicity
  • dementia
Full details

Diagnostic investigations

1st investigations to order

  • plain x-rays
Full details

Investigations to consider

  • MRI pelvis (without contrast)
  • CT pelvis (without contrast)
Full details

Treatment algorithm

ACUTE

intracapsular (femoral neck) fracture

extracapsular (intertrochanteric) fracture

Contributors

Expert advisers

Herman Johal, MD, MPH, FRCSC

Orthopaedic Trauma Surgeon

Assistant Professor

Department of Surgery

McMaster University

Hamilton, Ontario

Canada

Disclosures

HJ declares that he has no competing interests.

Acknowledgements

Dr Herman Johal would like to gratefully acknowledge Dr Bradley A. Petrisor and Dr Mohit Bhandari, the previous contributors to this topic.

Disclosures

BAP and MB declare that they have no competing interests.

Peer reviewers

Marc F. Swiontkowski, MD

Professor

Department of Orthopedic Surgery

University of Minnesota

Minneapolis

MN

Disclosures

MFS is Editor-in-Chief of the Journal of Bone and Joint Surgery.

Rudolf Poolman, MD, PhD

Consultant Orthopaedic Surgeon

Onze Lieve Vrouwe Gasthuis

Teaching Hospital with The University of Amsterdam

Department of Orthopaedic Surgery

Amsterdam

The Netherlands

Раскрытие информации

RP has been reimbursed by LINK for organizing education and research consultancy.

David Hackam, MD, PhD

Assistant Professor of Surgery

Children's Hospital of Pittsburgh

Pittsburgh

PA

Раскрытие информации

DH declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

Список литературы

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Основные статьи

American Academy of Orthopaedic Surgeons. Management of hip fractures in older adults: evidence-based clinical practice guideline. December 2021 [internet publication].Полный текст

American College of Radiology. ACR appropriateness criteria: acute hip pain. 2024 [internet publication].Полный текст

Статьи, указанные как источники

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