Treatment

Treatment for hip fracture usually involves a combination of surgery, rehabilitation and medication.

Surgery

The type of surgery you have generally depends on the where and how severe the fracture is, whether the broken bones aren't properly aligned (displaced), and your age and underlying health conditions. The options include:

• Internal repair using screws. Metal screws are inserted into the bone to hold it together while the fracture heals. Sometimes screws are attached to a metal plate that runs down the femur.
• Total hip replacement. Your upper femur and the socket in your pelvic bone are replaced with artificial parts (prostheses). Increasingly, studies show total hip replacement to be more cost-effective and associated with better long-term outcomes in otherwise healthy adults who live independently.
• Partial hip replacement. If the ends of the broken bone are displaced or damaged, your surgeon might remove the head and neck of the femur and install a metal replacement. Partial hip replacement might be recommended for adults who have other health conditions or cognitive impairment or who no longer live independently.

Your doctor might recommend partial or total hip replacement if the blood supply to the ball part of your hip joint was damaged during the fracture. That type of injury, which occurs most often in older people with femoral neck fractures, means the bone is less likely to heal properly.

Rehabilitation

Your care team will likely get you out of bed and moving on the first day after surgery. Physical therapy will initially focus on range-of-motion and strengthening exercises. Depending on the type of surgery you had and whether you have help at home, you might need to go from the hospital to an extended care facility.

In extended care and at home, you might work with an occupational therapist to learn techniques for independence in daily life, such as using the toilet, bathing, dressing and cooking. Your occupational therapist will determine if a walker or wheelchair might help you regain mobility and independence.