The hip is a 'ball and socket' joint, where the femur head sits in the acetabulum socket of the pelvis. A hip fracture commonly breaks at the top of the femur, rarely involving the socket.
Hip fractures are fairly common, affecting 70,000 UK patients annually, 80% of which are aged over 80. They usually occur after a fall, although they can happen in otherwise healthy and independent people.
Symptoms include: pain, swelling and bruising around the hip and upper leg; being unable to put weight on or move the affected hip and leg, which may be at an odd angle or shorter than the unaffected leg; tingling or loss of feeling in your hip or leg after an injury; severe hip pain starting suddenly without injury or fall; a swollen hip that feels hot, with the skin around it changing colour; hip pain and feeling generally unwell with a high temperature or shivery. Call 111 for advice, call 999 or go to the emergency department.
Hip fractures generally require surgery. There's now a well-established pathway proven to get the best outcomes. This involves prompt diagnosis by X-ray, admission to orthopaedic care and rapid comprehensive assessment - medical, surgical and anaesthetic, with minimal delay to surgery. Then, postoperatively: prompt mobilisation, usually on the first day; early multidisciplinary rehabilitation involving physiotherapy and occupational therapy; early supported discharge and ongoing community rehabilitation.
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