A suspected hip fracture is an emergency. Go to your nearest hospital immediately — do not arrange travel. Delay to surgery increases the risk of complications and death. This is one injury where the nearest capable hospital is the right hospital.
A broken hip in an older person is a medical emergency, not an orthopaedic inconvenience. The evidence on timing is unusually clear: surgery within about 48 hours produces better outcomes.
This page exists mainly to say one thing. If a relative has just broken their hip, they should be operated on where they are, urgently — not flown anywhere. We would rather lose the enquiry than take it.
Most hip fractures in older adults occur through bone weakened by osteoporosis, after a fall from standing height. The break occurs in one of two places, and the distinction determines the operation.
A fracture of the femoral neck — the narrow part just below the ball — can disrupt the blood supply to the femoral head. If it does, the head dies even if the fracture is fixed, which is why displaced neck fractures in older patients are usually treated by replacing the head rather than fixing it.
An intertrochanteric fracture occurs slightly lower, through the broader bone below. The blood supply is generally preserved, so these are fixed with a nail or plate rather than replaced.
What makes this an emergency is not the bone but the person. An older patient lying immobile with a broken hip develops chest infections, pressure sores, clots and delirium, and each day of delay compounds the risk. The evidence for operating within about forty-eight hours is among the more consistent findings in orthopaedic care.
There is also a longer view. A hip fracture is usually the first clear sign of significant osteoporosis, and it substantially raises the risk of a second fracture. Treating the bone afterwards is as important as fixing the break.
This is the most direct advice on our website. A hip fracture needs surgery within about forty-eight hours, and every day of delay increases the risk of pneumonia, clots, pressure sores, delirium and death. Arranging a flight takes days at best. Whatever the difference in cost or perceived quality, an operation tomorrow at your local hospital is better medicine than a better operation next week in Delhi. Have it done where you are, and contact us afterwards if there is a problem with the result.
Diagnosis is usually straightforward, but a normal X-ray does not always exclude a fracture.
Most people who reach this page do so after surgery has already happened — either because the result is poor, the fracture has failed to heal, or the implant has cut out. In that situation send the original X-rays, the post-operative films, the operation note, and current X-rays. Failed hip fracture surgery is a genuine reason to travel, unlike the acute injury itself.
Surgery is almost always the right answer. Which operation depends on the fracture pattern and the patient.
The fracture is stabilised with screws, or with a nail passed down the inside of the femur. Used for undisplaced neck fractures and for most intertrochanteric fractures, where the blood supply to the head is intact. It preserves the patient's own joint and is a shorter operation.
The femoral head is replaced but the socket is left alone. A shorter, less demanding operation than a full replacement, suited to frailer or less mobile patients with a displaced neck fracture, where the priority is getting them standing again quickly and safely.
Both the head and socket are replaced. For a fitter, independently mobile older patient with a displaced neck fracture, it gives better function and less residual pain than hemiarthroplasty, at the cost of a slightly higher dislocation risk and a longer operation.
Assessment and treatment of osteoporosis, vitamin D and calcium, review of medication that increases fall risk, and a home hazard assessment. A hip fracture substantially raises the risk of a second fracture, and this part of the treatment is the most frequently neglected.
Neck or intertrochanteric, displaced or undisplaced. This determines fixation versus replacement and is read directly from the X-ray.
A fit, independently mobile patient benefits from total hip replacement. A frailer patient is better served by a shorter, safer operation.
Above everything else. The right operation performed promptly beats the perfect operation performed late.
If you are contacting us about an acute hip fracture, our advice will be to have it treated where you are. That is not us declining your business — it is the correct clinical answer.
This is the one condition where our answer is almost always the same: go to your nearest hospital now. We will help afterwards if something goes wrong, and that is a genuine and common reason patients reach us.
Photographs taken on your phone are fine. Reports in Arabic, Russian or Bengali are fine — we translate them ourselves.
No. He should have surgery at the nearest capable hospital within about forty-eight hours. Delay while arranging international travel materially increases the risk of pneumonia, clots and death, and no difference in surgical quality outweighs that. Contact us afterwards if the result is poor — that is a situation we can genuinely help with.
Because the danger is immobility rather than the bone. An older person lying in bed with a broken hip is at high risk of chest infection, pressure sores, clots and delirium, and that risk accumulates daily. Operating promptly allows them to be sat up and mobilised, which is what prevents those complications.
It depends on where the fracture is. Fractures through the femoral neck can disrupt the blood supply to the ball, so displaced ones in older patients are usually treated by replacing it. Fractures lower down, through the trochanteric region, retain their blood supply and are fixed with a nail or plate.
This is worth investigating properly and is a legitimate reason to seek a specialist opinion. Possibilities include non-union of the fracture, cut-out of the implant, collapse of the femoral head from lost blood supply, or infection. Send the original and current X-rays with the operation note and we will give you an assessment.
A great deal, and it is the most neglected part of hip fracture care. Osteoporosis treatment substantially reduces the risk of a second fracture, alongside vitamin D and calcium, a review of medicines that cause dizziness, strength and balance exercise, and removing hazards at home. Ask whether bone protection has been started — often it has not.
Often yes. A bone density scan where risk factors exist, treatment if osteoporosis is confirmed, vitamin D supplementation, a review of sedating medication, exercise for strength and balance, and simple home changes such as lighting, rails and removing loose rugs. Prevention is far more valuable than any operation.
If the fracture is recent, please have it treated where you are today. If surgery has already been done and the result is poor, send the original and current X-rays with the operation note.
Your reports go directly to our medical team. We do not share your records with hospitals until you tell us to.
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