Treatment depends on the location of the fracture, the degree of displacement, the number of other fractures and the age of the person. A hip fracture usually is treated with surgery. In recent years, less invasive operations have been developed.
Fracture of the femoral head or neck — If the fracture is not displaced, the bones may be secured with pins and screws during minor surgery. Sometimes metal plates are used. A displaced fracture requires a hip replacement, a major operation. In hip-replacement surgery, the damaged femoral head is replaced with a metal or ceramic ball, which fits into an artificial socket that is cemented in place.
Fracture between the trochanters — Anyone with a fracture between the two trochanters should be treated immediately with traction, which involves the use of weights and pulleys to stretch and extend the muscles around the hip. Traction prevents the muscles that are attached to the trochanters from pulling the two sides of the fractured bone in different directions during the time it takes for the fracture to heal.
For people who participate in regular activity before an injury, traction should be followed by surgery to insert pins and screws into the hip to stabilize the broken bone. These people should begin to move the joint as early as possible after the pins and screws are placed.
This type of surgery may be too traumatic for people who were bedridden before the fracture. In those cases, the fractured bone should be kept immobilized. This immobilization may last four to eight weeks.
Fracture below the trochanters — Surgery involves placing a long metal rod in the shaft of the thighbone to realign the break. In young children, traction and a full leg cast may be all that is needed.
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