Introduction
Hip care · Hip fracture
Broken hip (hip fracture): treatment and recovery
Specialist orthopaedic surgeon · hip problems
Dr Sean LeoOrthopaedic Surgeon, Singapore
Clinic enquiries · Not an emergency service
Illustrative image
A broken hip needs urgent hospital care.
A broken hip needs urgent hospital care.
A broken hip needs urgent hospital care.
- A broken hip (hip fracture) is serious and needs treatment in hospital straight away.[2]
- It is a break of the upper part of the thigh bone, close to the hip joint, and it usually happens because of a fall or injury.[2][3][4][5]
- A broken hip is usually treated with surgery. The operation depends on where the bone has broken, and the care around it, including early movement and looking after your bone health, matters too.[1][2]
- OrthoKinetics is Dr Sean Leo’s professional brand. Clinical care is provided through OrthoSports Orthopaedic & Sports Surgery. Dr Sean Leo is a specialist orthopaedic surgeon who cares for hip problems.
What’s covered on this webpage
Follow the route in order, or jump to the stop you need. Stops you have read are marked.
A broken hip is a break of the upper thigh bone.
A broken hip is a break of the upper thigh bone.
A broken hip is a break of the upper thigh bone.
A broken hip (hip fracture) is a break in the upper part of the thigh bone, the femur. Doctors describe it by where along that bone the break sits, and there are three main places: the femoral neck, the intertrochanteric region and the subtrochanteric region. The next sections take them one at a time.[3][4][5]
A broken hip usually follows a fall, often in an older person.
A broken hip usually follows a fall, often in an older person.
A broken hip usually follows a fall, often in an older person.
A broken hip usually happens because of a fall or injury. It is more common in older people and in people who have osteoporosis, which is a condition of weaker bones.[2] In older people, a break can follow a low-energy fall rather than a serious high-impact injury.[4]
More common does not mean only. Broken hips also happen in younger people.[4] A fall is an accident, not a personal failing.
What does a broken hip feel like?
What does a broken hip feel like?
What does a broken hip feel like?
The clearest signal is what happens after a fall or injury. Severe hip pain after a fall or injury, or being unable to walk or put weight on your leg, is not something to wait on. A broken hip needs treatment in hospital straight away.[2][6]
You do not need to work out for yourself whether a hip is broken. If a fall has left you or someone you care for in severe hip pain, or unable to stand on the leg, the next step is hospital care.[6]
The type of break depends on where it sits on the thigh bone.
The type of break depends on where it sits on the thigh bone.
The type of break depends on where it sits on the thigh bone.
A hip fracture is named by where the break sits on the upper thigh bone. That location matters because it guides which operation is used.[1]
- Femoral neck fracture. The femoral neck is the part of the thigh bone that connects the long shaft of the bone to the ball (the femoral head) of the hip joint. A femoral neck fracture is a type of intracapsular hip fracture.[3]
- Intertrochanteric fracture. This is a break between the greater and lesser trochanter, the two bony bumps on the upper part of the thigh bone. It is a type of extracapsular fracture.[4]
- Subtrochanteric fracture. This is a break just below the lesser trochanter, the smaller of the two bony bumps. The subtrochanteric region is defined as within 5 centimetres below the lesser trochanter.[5]
Naming the type is your surgical team’s job, not yours. The point for you is that the location guides the treatment.
A broken hip needs hospital care straight away.
A broken hip needs hospital care straight away.
A broken hip needs hospital care straight away.
A broken hip needs treatment in hospital straight away.[2] If you think you or someone else may have broken a hip after a fall or injury, seek urgent medical care. In Singapore, call 995 or go to an emergency department.[6]
Safety note: This webpage is not an emergency service. If you have severe hip pain after a fall or injury, or you cannot put weight on your leg, seek urgent medical care. In Singapore, call 995 or go to an emergency department.[6]
An appointment for a hip assessment is a separate, later step and does not replace hospital care after a fall.
Surgery is the usual treatment for a broken hip.
Surgery is the usual treatment for a broken hip.
Surgery is the usual treatment for a broken hip.
A broken hip is usually treated with surgery.[1][2]
Surgery is only part of the care. Early movement after the operation (covered under recovery) and looking after your bone health (covered under preventing the next fracture) are part of the same pathway.[1][2]
Structure / Patient / Goal
Structure / Patient / Goal
Deciding together
Structure / Patient / Goal
S
Structure: what is affected?
Structure is the break itself: which type it is and where it sits on the thigh bone.
P
Patient: how does it affect you?
Patient means you as a whole person. Your age, your general health, how independent and active you were before the fall, and what you can safely do now all shape which options are reasonable.
G
Goal: what are you hoping to return to?
Goal is what matters to you, whether that is moving safely, walking, or living independently. A useful plan starts from a clear purpose.
Your plan
No single factor decides the plan alone.
The operation depends on the type of break.
The operation depends on the type of break.
The operation depends on the type of break.
Depending on things like your age and the type of break, surgery may fix the broken bones back into place using screws, nails, rods or plates, replace some of the damaged hip joint with an artificial part (a hemiarthroplasty), or replace all of the damaged hip joint with an artificial joint (a total hip replacement).[2]
| Type of break | What is usually done |
|---|---|
| Displaced femoral neck (intracapsular) fracture | The joint is replaced: a total hip replacement or a hemiarthroplasty.[1] |
| Intertrochanteric (trochanteric) fracture | A sliding hip screw is preferred over an intramedullary nail.[1] |
| Subtrochanteric fracture | An intramedullary nail is used.[1] |
This table describes UK guidance that informs the plain explanation here.[1] Your surgeon will explain what suits your own break.
Choosing between a full and a partial replacement is individual. A total hip replacement rather than a hemiarthroplasty may be considered for some people with a displaced femoral neck fracture.[1]
Who may be considered for a total hip replacement rather than a hemiarthroplasty
The guideline says a total hip replacement may be considered for people with a displaced femoral neck fracture who were able to walk independently out of doors with no more than the use of a stick, who do not have a condition or comorbidity that makes the procedure unsuitable for them, and who are expected to be able to carry out activities of daily living independently beyond 2 years.[1] This is a decision made by your surgical team, not a checklist to score yourself against.
Surgery for a broken hip usually happens on the day of, or the day after, you arrive at hospital.[1][2] That is a target rather than a guarantee, and it can change for medical reasons.[1]
Recovery takes weeks to months, supported by early movement.
Recovery takes weeks to months, supported by early movement.
Recovery
Recovery takes weeks to months, supported by early movement.
A broken hip usually takes several weeks or months to heal, but it can take longer.[2] There is no fixed date, and recovery is gradual and individual.
Soon after surgery you will start having regular physiotherapy to help you start standing and moving again.[2] Unless there is a medical or surgical reason not to, people are helped to get moving on the day after surgery.[1]
Care is coordinated across a team. From admission, the guideline describes a Hip Fracture Programme that plans rehabilitation around individual goals, to recover mobility and independence, and links with services such as falls prevention and bone health.[1]
What the coordinated team looks after
The Hip Fracture Programme described in the UK guideline includes an orthogeriatric assessment, rapid optimisation of fitness for surgery, early identification of individual goals for rehabilitation, continued coordinated review, and liaison with related services, particularly mental health, falls prevention, bone health, primary care and social services.[1]
It is important to say plainly that you may never get back the same strength and movement as you had before your break.[2]
Risks and complications
Risks and complications
Risks and complications
Recovery from a broken hip varies from person to person. You may never get back the same strength and movement as you had before your break.[2] The timing of surgery is a target, and it can be affected by how fit you are for the operation.[1]
The details of your own care, including what to expect and what the risks are for you, are discussed with your treating team.
Preventing the next fracture
Preventing the next fracture
Preventing the next fracture
Healing the break is the first half of the pathway. The second half is looking after your bones so that another fracture is less likely.
If you are over 50 and have broken your hip, a fracture liaison service can help you prevent further broken bones and keep your bones healthy.[2] This bone-health follow-up sits alongside the rest of your care, and the guideline lists bone health among the services that hip fracture care links with.[1]
Medicines and services are matters for your own treating team.
OrthoKinetics Recovery Reflection
Recovery reflection
If a fall can break your hip in an instant, what does it mean to rebuild the confidence to move safely again, step by step?
A broken hip tends to arrive suddenly, and what follows can feel like a different pace of life. Trust in your own steps may take a while to come back, and that is understandable. Rebuilding it is not a test to be rushed. It is something done in small pieces, with support around you.
What would it mean to treat the fracture as only the first half of the work, and protecting your bones as the second?
Healing the break is the part everyone can see. The quieter part is looking after the bones that will carry you afterwards. Seen together, the two halves make one piece of work, not a repair followed by an afterthought.
Two halves of one job: the break that heals, and the bones that go on being looked after.
Illustrative image
With you through the seasonsMeet Dr Sean Leo
Meet Dr Sean Leo
A consultant orthopaedic surgeon whose clinical focus is the knee, sports injuries and the lower limb.
- Dr Sean Leo is a consultant orthopaedic surgeon. OrthoKinetics is his professional brand; clinical services are provided through OrthoSports Orthopaedic & Sports Surgery at Mount Elizabeth Novena Specialist Centre and Connexion, Farrer Park Hospital.
- His clinical interests include sports injuries, including those in adolescent athletes; ligament reconstruction; realignment surgery; cartilage repair and joint-preservation approaches; knee replacement; and technology-assisted hip and knee surgery.
- The consistent aim is to return people to meaningful function and activity while avoiding unnecessary downtime.
- Qualifications: MBBS, MRCS (Ed), MMed (Ortho), FRCSEd (Ortho).
More detail: Meet Dr Sean Leo
- Training and career: Dr Leo trained in medicine at the National University of Singapore and served in the Singapore Armed Forces Medical Corps from 2000 to 2012, where his work included the care of soldiers in physically demanding roles. He completed postgraduate orthopaedic training in 2009 and a one-year clinical fellowship at Royal North Shore Hospital in Sydney, Australia, before joining Changi General Hospital as an orthopaedic consultant in 2012, where he later held the positions of Senior Consultant and Director of the Hip and Knee Service. With seniority, his educational contribution has evolved towards mentorship and support for junior doctors.
Questions people often ask
Common broken hip questions
Common broken hip questions
What is a broken hip (hip fracture)?
A broken hip (hip fracture) is a break in the upper part of the thigh bone, near the hip joint. It is serious and needs treatment in hospital straight away. It usually happens because of a fall or injury.[2][3]
Is a broken hip a medical emergency?
Yes. A broken hip is serious and needs treatment in hospital straight away. Severe hip pain after a fall or injury, or being unable to put weight on your leg, needs urgent medical care. In Singapore, call 995 or go to an emergency department.[2][6]
What are the different types of hip fracture?
A hip fracture is named by where the break sits on the upper thigh bone: the femoral neck, between the greater and lesser trochanter (intertrochanteric), or just below the lesser trochanter (subtrochanteric). The location guides which operation is used.[1][3][4][5]
What surgery is used for a broken hip?
A broken hip is usually treated with surgery. A displaced femoral neck fracture is treated by replacing the joint, trochanteric fractures are usually fixed with a sliding hip screw, and subtrochanteric fractures with an intramedullary nail. The choice is individual.[1][2]
How long does a broken hip take to heal?
A broken hip usually takes several weeks or months to heal, but it can take longer. Recovery is gradual and individual, and there is no fixed date. You may never get back the same strength and movement as before the break.[2]
What happens after a hip fracture?
Soon after surgery you start regular physiotherapy to help you stand and move again. Care is coordinated across a team, with rehabilitation goals set around you and links to services such as falls prevention and bone health.[1][2]
How can a second fracture be prevented?
After a broken hip, part of the plan is looking after your bone health to help prevent further broken bones. If you are over 50, a fracture liaison service can help. Your treating team can explain the options for you.[1][2]
Is a broken hip the same as having a hip replacement?
No. A broken hip is an injury that needs hospital care straight away. Some broken hips are treated by replacing some or all of the hip joint, but a planned hip replacement for a worn joint is a separate decision, explained on the hip replacement page.[1][2] If you are wondering whether hip pain that did not follow a fall is arthritis, the hip osteoarthritis page explains how that question is approached, and the hip hub points to where the other hip problems are covered.
What is a femoral neck fracture?
A femoral neck fracture is a break in the femoral neck, the part of the thigh bone that connects the long shaft of the bone to the ball (the femoral head) of the hip joint. It is a type of intracapsular hip fracture.[3]
Costs and insurance
Costs and insurance
Practicalities
Cost, Medisave and insurance
Ask the clinic team for current information about fees, panel status, pre-authorisation and expected payment arrangements. Insurance coverage and out-of-pocket costs depend on the individual policy and the insurer’s decision; no coverage is guaranteed.
A cost estimate for surgery can be given only after a consultation and assessment, once a surgical plan has been developed. Each individual condition is unique — implants used, time taken, and other factors contribute to the overall estimate. The estimate will be provided to you by the clinic should you decide on surgical management, and will also be used to assist in obtaining pre-authorisation from insurance where applicable.
Insurance panels. Dr Sean Leo, Orthopaedic Surgeon, is on the specialist panels of Great Eastern (GE Panel), HSBC Life (HSBC Life Shield) and Singlife (Singlife Shield), and on the Prudential Panel. AXA Insurance Singapore became part of HSBC Life in 2023, and former AXA Shield plans are now HSBC Life Shield plans.
Corporate health plans. Dr Leo is on the panels of both Alliance Medinet and iXchange, which administer medical benefits for many company health plans. If your company plan uses either panel, you can see Dr Leo as a panel doctor.
If your company uses a different panel. Some company plans still let you see a doctor of your choice outside their panel, then claim reimbursement. This varies from plan to plan, as may the co-payment, so please check your benefits with your company’s HR department.
Panel arrangements change from time to time, so please confirm with your insurer or your company’s plan administrator before your appointment.
Dr Leo is on the panels shown. If your insurer is not listed, you may ask whether co-management with an Orthosports surgeon partner on that panel is clinically and administratively appropriate. Orthosports surgeon partners are collectively on the panels of all Shield plans.
Specific benefits, pre-authorisation, reimbursement and cashless treatment depend on the individual policy and insurer approval and are not guaranteed.
Arrange a consultation: the appointment section is further down this page.
Sources
References
References
- National Institute for Health and Care Excellence (NICE). Hip fracture: management. Clinical guideline CG124 (2011, updated 2017, 2023). Available at: https://www.nice.org.uk/guidance/cg124/chapter/Recommendations
- NHS. Broken hip. Available at: https://www.nhs.uk/conditions/broken-hip/
- Kazley JM, Bagchi K. Femoral Neck Fractures. StatPearls. NBK537347. Available at: https://www.ncbi.nlm.nih.gov/books/NBK537347/
- Attum B, Pilson H. Intertrochanteric Femur Fracture. StatPearls. NBK493161. Available at: https://www.ncbi.nlm.nih.gov/books/NBK493161/
- Medda S, Reeves R, Pilson H. Subtrochanteric Femur Fractures. StatPearls. NBK507803. Available at: https://www.ncbi.nlm.nih.gov/books/NBK507803/
- NHS. Hip pain in adults. Available at: https://www.nhs.uk/symptoms/hip-pain/
Final next step
Final next step
Next step
Final next step
Reading about a problem is a starting point. An assessment brings together the history, an examination where needed and any useful tests, and helps you and your clinician decide what to do next. How much physical examination is needed is a matter of clinical judgement. It may be limited when pain makes an examination unreliable, or when imaging clearly shows a problem that matches the symptoms, such as a fracture seen on an X-ray or an MRI scan that clearly shows an injury consistent with the symptoms. The Singapore Medical Council and the UK General Medical Council both allow remote medical consultations, where a physical examination is not possible, with safeguards: the doctor must be clear about the limits of an opinion formed without an examination, and whether an in-person examination is needed, or referral to other services, is left to the clinical judgement of the attending doctor.
If a hip problem may need urgent attention, such as after a fall or if you cannot bear weight, seek urgent medical care.[6]
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