Hip fractures

Last reviewed: 3 Jan 2023
Last updated: 02 Nov 2022

Summary

Definition

History and exam

Key diagnostic factors

  • inability to bear weight
  • pain in affected leg/hip
  • pain with hip movement
More key diagnostic factors

Other diagnostic factors

  • shortened and externally rotated leg
Other diagnostic factors

Risk factors

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

Diagnostic investigations

1st investigations to order

  • plain x-rays
More 1st investigations to order

Investigations to consider

  • MRI pelvis (without contrast)
  • CT pelvis (without contrast)
  • technetium bone scan
More investigations to consider

Treatment algorithm

ACUTE

intracapsular (femoral neck) fracture

extracapsular (intertrochanteric) fracture

Contributors

Authors

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

Disclosures

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

Disclosures

DH declares that he has no competing interests.

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