Hip fractures occur predominantly in older people. The risk increases significantly with age.
Associated most commonly with low-energy injury (e.g., fall from standing height) and osteoporosis or osteopenia.
Treatment is most commonly surgical. The choice of implant depends on the fracture pattern and the surgeon's preference.
A hip fracture is generally considered to be any fracture of the femur distal to the femoral head and proximal to a level a few centimeters below the lesser trochanter.
History and exam
Key diagnostic factors
- inability to bear weight
- pain in affected leg/hip
- pain with hip movement
Other diagnostic factors
- shortened and externally rotated leg
- age over 65 years
- low body mass index
- female sex
- high-energy trauma
1st investigations to order
- plain x-rays
Investigations to consider
- MRI pelvis (without contrast)
- CT pelvis (without contrast)
- technetium bone scan
intracapsular (femoral neck) fracture
extracapsular (intertrochanteric) fracture
- Acetabular fracture
- Pubic rami fracture
- Femoral shaft or subtrochanteric femur fracture
- Prevention of surgical site infections after major extremity trauma: appropriate use criteria
- Perioperative management of antithrombotic therapy
OsteoporosisMore Patient leaflets
- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer