A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. Hip fractures most commonly occur from a fall or from a direct blow to the side of the hip. Some medical conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking.
Generally, fractures of the hip are stabilized with surgery, however certain types of fractures may be considered stable enough to be managed with nonsurgical treatment.
The patient who has a hip fracture will typically have pain over the outer upper thigh or in the groin. There will be significant discomfort with any attempt to flex or rotate the hip or put weight on that extremity. If the bone is completely broken, the leg may appear to be shorter than the non-injured leg. The patient will often hold the injured leg in a still position with the foot and knee turned outward (external rotation).
What to expect from therapy
Treatment and rehabilitation for a hip fracture is designed to relieve pain, restore range of motion, and restore strength—in that order. Whether the fracture requires surgery or not there is typically a period of time with weight bearing restrictions. The amount of weight that is allowed to be placed on the injured leg will be determined by the surgeon and is generally a function of the type of fracture and repair (fixation). Non- or partial weight bearing results in atrophy of muscle and restrictions in range of motion (ROM) and flexibility. Manual therapy (hands on) techniques employed by a physical therapist can often provide relief of symptoms and promote realignment of tissues and ROM. Complete restoration of function will also include a comprehensive exercise program emphasizing flexibility, strength, balance and ambulation.