How to recognise a broken hip

Di Websdale-Morrissey explains how to recognise and respond to a possible broken hip

Di Websdale-Morrissey explains how to recognise and respond to a possible broken hip.

Although we speak of a broken hip (medical name fractured [broken/cracked] neck of femur [NOF]), the break is usually in the narrow area between the head of the femur (thigh bone) and its outer bony protuberance (see diagram). This section of bone is prone to snapping if someone with brittle bones falls on their hip. People of any age can break a hip, but the elderly, particularly osteoporotic women, are most at risk.

What are the outer signs?
The person will experience pain in the upper thigh and groin if you attempt to move/rotate their hip. The person’s leg on the affected side may appear shorter than the other leg and be rotated outward, although this only happens in certain circumstances. If the person is elderly and has fallen onto his/her hip, assume a fracture until medical examination excludes it.

What symptoms might a sufferer report?
Pain in the groin area with any attempt to move or weight-bear. Be aware that the elderly have higher pain thresholds than the
young and might downplay their level of discomfort.

Action plan

If you have acute symptoms:
Summon help as best you can.

If someone else has the symptoms:
• call 000 for an ambulance
• keep the patient calm and comfortable
• moisten their mouth, or give small sips of water only if they
are thirsty; do not give anything else in case they need
emergency surgery
• doctors will need to know if there is an underlying cardiac/
neurological condition or medication issue they should be
aware of. While the patient is reasonably calm and awake, try
to find out and record the following:
How did the fall happen – a simple trip or did they faint or
experience any loss of consciousness that led to the fall?

• What is their recent medical history – heart problems?
Neurological problems? Lung, kidney, circulation problems?
• When did they last eat and drink?

• if you are in their home, gather any of the person’s regular
medications to give to staff at the hospital. If you are with them
on the street, ask for their GP’s name.

Predisposing factors
• age
• osteoporosis
• history of falls/fainting.

What is the prognosis?
This will depend on the level of general health and nutrition of the patient, but provided help is given promptly, the outcome
should be good. In most cases, surgery within the first 24 hours is indicated, but for others less invasive options such as
traction might be used.

Prevention

Good nutrition with an emphasis on calcium and vitamin D intake will help keep osteoporosis at bay. When the elderly
become unsteady on their feet or start to report having ‘funny turns’ etc., families could consider getting an alarm for them to
wear at all times. If a person falls and can’t reach a phone, they can trigger the alarm to summon help.







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