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Treatments and drugs
By Mayo Clinic staff
Surgery is almost always the best hip fracture treatment. Doctors typically use nonsurgical alternatives, such as traction, only if you have a serious illness that makes surgery too risky.
The type of surgery you have generally depends on the part of the hip that fractured, the severity of the fracture and your age. Generally, the better your health and mobility before your hip fracture, the better your chances for a complete recovery from a hip fracture.
Femoral neck fractures
Doctors repair this type of fracture by one of three methods:
- Metal screws. If, after the break, the bone is still properly aligned, your doctor may insert metal screws into the bone to hold it together while the fracture heals. This is called internal fixation.
- Replacement of part of the femur. If the ends of the broken bone aren't properly aligned or they've been damaged, your doctor may remove the head and neck of the femur and replace them with a metal prosthesis. This is known as hemiarthroplasty.
- Total hip replacement. This procedure involves replacing your upper femur and the socket in your pelvic bone with a prosthesis. Total hip replacement may be a good option if arthritis or a prior injury has damaged your joint, affecting its function prior to the fracture.
In general, the older you are the more likely you are to receive a prosthesis. That's because older people aren't likely to wear out a prosthesis and so won't need additional surgery. Also, it's even more important for older adults to get moving again quickly after surgery to prevent serious complications.
Intertrochanteric region fractures
To repair this type of fracture, your doctor usually inserts a metal screw (hip compression screw) across the fracture. The screw is attached to a plate that runs down alongside the femur and is attached with other screws to help keep the bone stable. As the bone heals, the screw allows the bone pieces to compress, so the edges grow together.
Hospital stays after hip fracture surgery generally last less than a week. Afterward, you may continue to meet with a physical therapist. Extended care facility stays are often required for those who can't bear weight on their hip after surgery and who don't have assistance at home.
Medication
While surgery is the primary treatment for a hip fracture, a 2007 study in the New England Journal of Medicine found that once-yearly infusions with the intravenous medication zoledronic acid (Reclast, Zometa) might be helpful in treatment of hip fracture. When zoledronic acid is started within three months of the fracture, the rates of new fractures were reduced and survival odds improved.
