Hip Fracture broken hip femoral neck fracture intertrochanteric fracture
The hip joint is formed where the head of the femur (the thigh bone), meets the acetabulum (the socket of the pelvis).
The term “hip fracture” usually refers to breaks in the femoral neck or between the bony prominences at the base of the neck known as the trochanters. 
Hip fractures are much more common in the elderly.  Age and hormonal changes lead to more brittle bones, a condition known as osteopenia or osteoporosis.  Hip fractures are usually the result of a fall onto the hip in a person with osteopenia or osteoporosis.
Hip fractures are diagnosed based on a history, physical exam, and x-rays.  Younger patients report a traumatic injury such as a motor vehicle accident.  Older patients have usually fallen.  The injury results in immediate pain and inability to bear weight on the broken hip.
During the physical exam, the hip is tender at the fracture site.  There may be a deformity such as a rotated hip or shortening of the leg.  Pain is present with rolling the leg in or out.
X-rays should be obtained to confirm the presence of a hip fracture.  X-rays are also important to evaluate the fracture.  The location of the fracture and the amount of displacement of the broken fragments are important factors in planning treatment.  A CT scan is sometimes obtained for further evaluation if a more detailed or 3-dimensional view is needed.
Non-surgical treatments for hip fractures is only considered when the patient is at extreme medical risk for undergoing surgery and sometimes if the patient has severe dementia, does not normally walk, and is not in much pain.  Non-surgical treatment involves non-weightbearing on the broken hip.  It is important to get the patient up in a chair frequently to avoid complications that arise from bedrest including blood clots, bed sores, and lung problems.
Non-displaced femoral neck fractures may be treated with percutaneous screw fixation.  This means that only small incisions are made--just big enough to place screws that pass through the femoral neck and stabilize the fracture.
intertrochanteric fracture
femoral neck fracture
femur ilium sacrum pubis femoral head ischium acetabulum (socket)
greater trochanter
lesser trochanter
medial condyle
lateral condyle
femoral neck fractures
trochanteric fractures
Displaced femoral neck fractures often require hemiarthroplasty.  This is when the femoral head is removed and replaced with a prosthesis.
Intertrochanteric fractures are usually treated with a sliding hip screw or an intramedullary hip screw.
sliding hip screw
intramedullary hip screw
Following surgery, a stay in the hospital is usually necessary.  Whatever the method of fixation, full weight-bearing is encouraged within 24 hours of surgery.  A walker is usually necessary for stability, although many patients are able to abandon the walker after a short while.  Physical therapy can be helpful for strengthening and gait training.  Many patients are able to return to their pre-injury level of function.