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Hip Fracture 101:
Causes, Risks & Treatments

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A hip fracture is a break in the upper part of the thigh bone (femur), located near the hip joint. Hip fractures are especially dangerous for older adults, as their weak bones make them more prone to injury from a simple fall, and can lead to long-term disability and loss of independence. In this article, we explain everything you need to know about a hip fracture and how you can lower your risk of sustaining one.

By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun

What Causes Hip Fractures?

Hip fractures usually involve having weakened bones and/or a significant force:

Falls: Even a simple slip or loss of balance can cause a fracture, especially in individuals with weaker bones.
High-Impact Trauma: Severe accidents, such as car crashes or falls from a significant height, can result in a hip fracture.
Sports Injuries: Activities such as football, basketball, or martial arts carry a higher risk due to sudden movements, falls or collisions that can lead to hip fractures.
Underlying Medical Conditions: Conditions such as hyperthyroidism, intestinal disorders, or bone tumours can weaken the bones, making them more prone to fractures.

Risk Factors for Hip Fractures to Look Out For

Several factors can increase the likelihood of experiencing a hip fracture:

Age: As people get older, bones weaken and balance declines, making falls and fractures more likely.
Gender: Women, especially those who are postmenopausal, face a higher risk due to faster bone density loss.
Osteoporosis: This condition causes bones to thin and weaken, making them more vulnerable to fractures even from minor impacts.
Previous Fractures: A history of fractures indicates a weakened bone structure, which increases the risk of future breaks.
Medications: Certain medications, such as sedatives, antidepressants or corticosteroids, can cause dizziness or reduce bone strength, thereby increasing the risk of falls.
Environmental Hazards: Slippery floors, cluttered spaces and poor lighting can lead to trips and falls, especially in older adults.

Can Hip Fractures be Prevented?

While not all hip fractures can be prevented, there are certain things you can do to reduce your risk of sustaining one in the future.

Build Bone Strength: Ensure you consume adequate amounts of calcium and vitamin D.
Exercise Regularly: Do weight-bearing, resistance and simple balance work.
Make Your Home Safer: Remove trip hazards, add grab bars/handrails, improve lighting and wear non-slip shoes.
Review Medications & Health: Check if any medications you’re taking cause dizziness. Check your vision and hearing; and manage low blood pressure better.
Healthy Habits: Do not smoke, limit alcohol, have a balanced diet and maintain a healthy weight.
If at a Higher Risk: Use a cane or walker if advised, and consider using hip protectors.

What are Signs & Symptoms of a Hip Fracture?

A hip fracture often causes sudden, intense symptoms that will require immediate medical attention. Common ones include:

Severe pain in the hip or groin area
Inability to stand, walk or bear weight on the affected leg
A shortened or outwardly rotated leg on the side of the injury
Swelling, bruising or stiffness around the hip joint
Limited range of motion, making it difficult to move the hip comfortably

If you experience these symptoms following an incident, seek medical care as soon as possible.

How Are Hip Fractures Diagnosed?

The doctor will check for key signs such as severe pain, inability to move or bear weight on the affected leg, and any visible changes, including a shortened or outwardly rotated leg. To confirm the diagnosis and assess the severity of the injury, imaging tests are performed. X-rays are typically used first to identify the location and type of fracture. In more complex cases, CT scans may be required to provide a clearer, more detailed view of the break. MRI scans may be used when a fracture is suspected but not visible on X-rays.

How Are Hip Fractures Treated?

Treatment for a hip fracture typically involves surgery, followed by a structured rehabilitation programme to restore mobility and strength.

Hip Fracture Surgery

Most patients with hip fractures require surgery to stabilise or repair the broken bone. The type of surgery depends on the location and severity of the fracture:

Internal Fixation: For fractures that can be realigned, the surgeon uses screws, plates or rods to hold the bone fragments together while they heal.
Partial Hip Replacement: If the fracture only affects the ball of the hip joint (femoral head), this part is replaced with an artificial implant, leaving the rest of the joint intact.
Total Hip Replacement: In severe cases, both the ball and socket (acetabulum) of the joint are replaced with prosthetic components for optimal function and pain relief.

Rehabilitation & Recovery from a Hip Fracture

Physiotherapy typically starts soon after surgery, often within 24 to 48 hours, depending on the patient’s condition and the type of procedure performed. A physiotherapist will guide you through progressive exercises to restore hip motion, strengthen surrounding muscles, and retrain your balance and gait. You may have to start with a walker or crutches and advance to a cane, then independent walking.

Most people regain basic independence in 4 to 6 weeks, with continued improvement in strength and over the next few months depending on age, bone quality and overall health. Consistency is key: attend physiotherapy sessions, complete your home exercises, and follow weight-bearing instructions.

If you suspect that you or a loved one might have a hip fracture, please do not delay seeking medical attention. Contact us today for a thorough evaluation and personalised treatment to help you achieve optimal recovery.

Dr Wang Lushun

Senior Consultant Orthopaedic Surgeon

MBBS (S’pore), MRCS (Edin), MMed (Ortho), FRCS (Ortho) (Edin)

With over 18 years of experience, Dr Wang Lushun is an orthopaedic surgeon who specialises in treating a wide range of sports injuries and musculoskeletal conditions. He has in-depth experience in minimally invasive surgery and advanced robotic surgery. Dr Wang provides orthopaedic care to athletes and everyday individuals throughout their journey to recovery.