Hip fractures are serious, debilitating injuries that usually occur in older adults. They commonly occur in one of three different locations: the femoral neck, the intertrochanteric region, or the subtrochanteric region of the proximal femur (thighbone). All of these fractures will result in loss of the ability to walk, and they generally cause severe pain. Non-operative treatment is usually not an option because of continued pain, the need for long term bed-rest, and concern for many medical problems related to immobility.
Operative treatment is therefore almost always recommended, in order to allow the patient an expedient return to weight-bearing and function. The type of injury determines the exact procedure required to fix the problem. The three main types of hip fracture surgery include pinning, intramedullary nailing, and hemiarthroplasty (a half-hip replacement). In rare cases, a full hip replacement may even be necessary. For more information about surgical procedures, please visit the Hip Procedures page.
After surgery is performed, patients will begin Physical Therapy while still in the hospital. Once the patient is medically stable they will be discharged either to an inpatient rehabilitation unit, to a skilled nursing facility, or directly home.
In order to receive hospital-based rehabilitation, an evaluation is performed on the patient by the staff from the rehabilitation unit. There are several medical criteria that the patient must meet in order to be accepted into the rehabilitation unit. Increasingly, insurance companies also determine whether a patient is approved for hospital-based rehabilitation. If accepted into the rehabilitation unit, the average patient will usually stay there for 10-14 days before returning home.
Sometimes, however, a hip fracture results in a major change in lifestyle wherein a patient is no longer able to function independently. These situations may require the patient to enter a long-term skilled nursing facility. Sometimes the patient will be able to eventually return home or to an assisted-living facility after recovering their strength and ability to walk, but sometimes patients may end up staying in the skilled nursing facility indefinitely.
The patient and their family have a choice of nursing facilities based on availability. Please refer to our list of local nursing facilities and agencies.