Understanding your injury

A hip fracture breaks the upper femur, including the femoral neck or the bone just below it. It can follow a fall in weakened bone or a higher-energy injury. Hip or groin pain and difficulty standing after a fall need urgent hospital assessment. X-rays establish the pattern; further imaging may be needed when suspicion remains despite normal initial X-rays. The team also assesses other injuries and medical problems.

Treatment and the procedure

Most hip fractures need an operation, with prompt surgery after necessary medical assessment and treatment. Fixation may use screws, a plate and sliding screw, or a nail inside the femur. Some femoral neck fractures are treated with partial or total hip replacement. Selection depends on displacement, blood supply, previous mobility, age and health. Nonoperative care is reserved for selected circumstances and includes a careful discussion of pain, mobility and medical risks.

Benefits, risks and expectations

If surgery is planned, discuss bleeding, anaesthetic risks and complex regional pain syndrome as well as the risks specific to your injury. Your general health and the extent of surgery affect your personal risk.

The aim is pain relief and enough stability to resume movement and rehabilitation. Some people do not regain their previous mobility or independence.
Discuss bleeding, infection, blood clots, medical or anaesthetic complications, confusion or delirium and further surgery. Fixation can fail to heal or lose position; femoral head blood supply can be damaged.
Replacement introduces different risks, including dislocation and implant problems. Your team explains the risks of the proposed operation and the fracture itself.

Rehabilitation and aftercare

Rehabilitation usually begins early when medically safe, under the team's loading instructions. Physiotherapy and occupational therapy help with walking aids, transfers, washing and dressing. Follow wound care and clot-prevention prescriptions, and raise pain, constipation or nutritional difficulties. Arrange the support needed at home or in rehabilitation. Following a fragility fracture, bone-health assessment and falls prevention are important parts of recovery.

When to get urgent help

After a fall, severe hip pain or inability to walk requires emergency assessment; call 999 for an ambulance. After treatment, seek urgent review for fever, wound discharge or a sudden change in function.
Call 999 for chest pain or severe breathlessness. New calf pain and swelling needs urgent assessment.

Your consultation

Ask why fixation or replacement is recommended, what mobility is realistic and what help will be needed after discharge. The individual consent discussion includes reasonable alternatives and your priorities.

Your consent discussion

Use the patient pack to record your priorities, the proposed procedure, its alternatives, the benefits you hope for and risks that matter to you. A clinician will discuss your individual circumstances and complete the appropriate hospital consent process with you.

Reading or downloading a guide does not give consent. You can ask further questions, decline treatment or change your mind before the procedure.

Hip and proximal femur fractures