Overview
A hip fracture is a break in the upper part of the thigh bone (femur) near the hip joint, most commonly from a fall or, in people with weaker bones, from a minor injury. It can involve the femoral neck or the intertrochanteric area, which are critical for walking because they support the body's weight. When the fracture occurs, the bone becomes unstable and inflamed, causing deep hip or groin pain and making it difficult to move the leg normally. Even when the skin wound is small, a hip fracture often needs careful medical assessment to protect healing and prevent complications.
Symptoms
Hip fractures usually cause sudden pain in the hip or groin, often after a fall. Many people cannot bear weight and may have pain with any attempt to stand, walk, or even gently move the hip. In some cases the leg may look shorter or be rotated outward, and bruising and swelling can develop. Range of motion is typically very limited, and people often rely on a limp or cannot walk at all.
Causes
Most hip fractures are caused by traumatic falls, especially in older adults or when balance is impaired. In people with osteoporosis or other bone-weakening conditions, the fracture may occur with relatively low-impact injuries. Less commonly, repeated stress to the bone can lead to a fracture pattern that may be mistaken for soft-tissue pain at first.
Risk Factors
The biggest risk factor is advancing age, because bone density and protective reflexes tend to decline. Osteoporosis, a history of prior fractures, and low body weight increase risk, and so do medications that affect balance or alertness such as sedatives. Vision problems, poor strength and balance, smoking, and heavy alcohol use can also increase the likelihood of falls and fragility fractures.
Prevention
You can reduce risk by preventing falls, including improving lighting, removing loose rugs, using grab bars, and wearing appropriate footwear. Regular strength and balance training, such as supervised exercises for leg strength and gait stability, can improve walking confidence and stability. For people with osteoporosis or known low bone density, appropriate treatment and lifestyle measures like adequate calcium and vitamin D intake can help reduce future fracture risk.
How the Diagnosis Is Evaluated
Clinicians start with a history of the fall or injury and ask about pain location, ability to bear weight, and any visible deformity. A physical exam evaluates hip range of motion, leg alignment, tenderness, and circulation and nerve function. Imaging is used to confirm the diagnosis, typically with X-rays, and CT or MRI may be ordered if the X-ray is negative but a hip fracture is still strongly suspected (such as severe pain or inability to bear weight).
Nonsurgical Treatment Options
Nonoperative management may be considered only in selected cases, such as certain stable, nondisplaced fractures, and it requires close follow-up to ensure the fracture is healing and not shifting. Treatment focuses on protecting the healing bone with restricted or protected weight bearing as directed, using assistive devices like a walker or crutches. Pain control is individualized, often starting with acetaminophen and using other options carefully based on your health history. Physical therapy helps maintain safe mobility, strengthen surrounding muscles, and reduce complications from inactivity, including stiffness and deconditioning. Clinicians also address medical contributors to fracture risk, such as evaluating and treating osteoporosis and preventing blood clots if appropriate.
When to Seek Medical Attention
Seek emergency care or urgent medical evaluation immediately if you have hip pain after a fall, cannot bear weight, or notice leg shortening or outward rotation. Prompt attention is also needed for rapidly increasing swelling, severe uncontrolled pain, fever, or new numbness, weakness, or color changes in the leg. If you have been diagnosed with osteoporosis and sustained even a minor injury with persistent hip or groin pain, contact a clinician the same day.
Frequently Asked Questions
Hip fractures often cause sudden hip or groin pain after a fall and an inability to bear weight, but imaging is required to confirm the diagnosis.
Get urgent medical attention, avoid bearing weight, keep the person as still as possible, and use appropriate pain control while waiting for assessment.
Next Steps
If you suspect a hip fracture, seek same-day medical evaluation, especially if you cannot bear weight or have deformity after a fall. Follow the clinician's instructions for protected mobility and plan for physical therapy and bone health evaluation to support healing and reduce the risk of another fall.