What Are the Symptoms of a Hip Fracture?

A hip fracture typically causes sudden, intense pain in the hip area, groin, or upper thigh, often after a sudden fall or injury. Other symptoms of a hip fracture may include inability to stand, walk, or bear weight, visible bruising/swelling, deformity, and restricted movement.

At Total Orthopedics and Sports Medicine, Dr. Charles Ruotolo performs a detailed physical examination and advanced imaging to confirm the type of fracture and identify associated risk factors. Based on your condition, he may recommend advanced treatment options such as hip surgery, fracture stabilization, or total hip replacement to help restore strength and mobility. If you’re seeking professional treatment for your broken hip in East Meadow, call us at 855-321-6784.

How Can You Tell If Your Hip Is Fractured?

You may have a fractured hip if you develop physical deformity or if the affected leg appears to rotate outward. Other symptoms of hip fracture may include difficulty bearing weight, standing, or walking on the affected leg following an injury or fall. Swelling, bruising, stiffness, and pain with movement are also serious warning signs that require urgent medical evaluation.

These symptoms can worsen over time, especially if you continue walking on the injured side. Moreover, you may experience severe hip pain in different areas, depending on the exact location and severity of the fracture, such as:

• Groin pain: Deep groin pain is common if the fracture involves the upper part of the thigh bone near the hip joint. This pain may worsen while standing, walking, or rotating the leg.
• Outer hip pain: Pain on the outside of the hip may occur if the fracture involves the upper femur or surrounding bone structures. The area may also feel tender to the touch.
• Thigh pain: Some people feel pain traveling down the front or side of the thigh because the hip and thigh bone share connected nerves and muscles. This can make walking or lifting the leg difficult.
• Buttock pain: Pain in the buttocks can develop if an injury affects the back of the hip or nearby soft tissues. It may be more noticeable when you try to sit, shift position, or stand.

What Are the Risk Factors for a Broken Hip?

Most hip fractures occur due to osteoporosis, frequent falls, poor balance, weak muscles, vision problems, low body weight, previous fractures, smoking, and heavy alcohol use. The risk of hip fractures is also high in older adults whose bones are fragile, and mobility is reduced.

In addition, conditions such as arthritis, Parkinson’s disease, stroke, diabetes, dementia, and nerve problems may increase the chances of hip fractures. Some medications, such as sleeping pills, sedatives, antidepressants, blood pressure medicines, and steroids, can also increase the risk of hip fractures. Similarly, environmental hazards such as loose rugs, cluttered walkways, poor lighting, slippery bathroom floors, uneven steps, and a lack of handrails can increase the risk of falls. Here’s how these factors increase the risk of hip fractures:

Age

As people grow older, their bones naturally become weaker and thinner, especially if they have osteoporosis. In fact, according to the NCBI report, it was found that 50% of women and 20% of men aged over 50 years will experience an osteoporosis-related fracture. Besides that, older people may also have reduced mobility, slower reflexes, poor balance, weaker muscles, and vision problems.

These changes increase the chance of falling, and because the bones are more fragile, even a minor fall can cause a hip fracture. Moreover, in some cases, older adults with a hip fracture may not show obvious symptoms. Instead, they complain of vague pain in areas such as the buttocks, knees, thighs, or groin without a clear history of trauma.

Environmental Factors

Environmental hazards increase the risk of falls, which may lead to hip fractures. For example, loose rugs, cluttered walkways, poor lighting, slippery bathroom floors, uneven steps, and a lack of handrails can all cause a person to trip, slip, or lose balance. Older adults are especially vulnerable to slips because they may not react quickly enough to prevent a fall. When they fall suddenly, the hip often absorbs the impact, which can lead to a serious injury. In addition, high-impact accidents, such as car crashes, can lead to hip fractures, particularly in younger individuals.

Health Disorders

Certain health conditions can increase the risk of hip fractures by making walking, balance, and body control more difficult. For example, arthritis can cause referred pain in the knee joint, stiffness, and limited movement, making balance difficult and increasing the risk of falls. Similarly, Parkinson’s disease can lead to tremors, muscle strain, and poor coordination, while a stroke may cause weakness or paralysis on one side of the body.

Other conditions, such as dementia, diabetes, and nerve problems, can also raise the risk. For example, dementia may affect judgment and awareness of danger, so a person may not notice hazards around them. Likewise, diabetes and nerve problems can reduce sensation in the feet, making it difficult to sense the ground properly. As a result, the person may trip, slip, or lose balance more easily.

Genetics

Some people inherit weaker bone structure or a family tendency toward osteoporosis. A family history of fractures may indicate lower bone density or bones that lose strength more quickly with age. Genetic factors can also affect body frame, muscle strength, balance, and the body’s ability to use calcium and vitamin D, all of which affect bone health. As bone strength declines, even a low-impact fall can result in a hip fracture, a serious injury that often requires immediate medical attention and surgical treatment.

Lifestyle and Nutrition

Lifestyle choices such as smoking directly affect bone strength, which can reduce bone density and slow bone healing. Similarly, heavy alcohol use is the most common cause of hip fractures because it can weaken bones and impair balance. Additionally, poor nutrition, especially low intake of calcium, vitamin D, and protein, can lead to weak bones. Low body weight also increases fracture risk because there is less body padding during a fall.

Medications

Some medications increase hip fracture risk by causing dizziness, sleepiness, low blood pressure, confusion, or poor balance. For instance, sleeping pills, sedatives, antidepressants, and some blood pressure medicines may increase the risk of falls. According to PubMed research, benzodiazepines and Z-drugs are associated with increased hip fracture risk in older adults.

Another NCBI review reported that chronic glucocorticoid therapy is linked with bone loss and fractures, including fractures of the femoral neck of the hip. Similarly, long-term use of steroids can also weaken bones, increasing the risk of osteoporosis. When medications affect both balance and bone strength, the chance of hip fracture may increase significantly.

Can a Hip Fracture Cause Leg Shortening or Rotation?

Yes, a hip fracture can cause the affected leg to appear shorter and rotate outward, especially if the broken bone fragments shift out of alignment. When muscles around the hip pull the fractured bone segments apart, the leg may appear shorter than the uninjured side. Outward rotation can also occur because the muscles and loss of structural support allow the leg to rest in an abnormal position.

However, the degree of shortening depends on the type and severity of the fracture:

1. Type of Hip Fracture

Intracapsular fractures, such as those on the femoral head, may cause slight shortening. This is because the break occurs within the hip joint capsule, and the bone fragments often remain partially aligned. In contrast, extracapsular fractures, including subtrochanteric and intertrochanteric fractures, usually result in increased shortening because larger segments of the femur are displaced.

2. Severity of the Fracture

Displaced fractures, where bone fragments shift significantly, always lead to visible shortening and outward rotation of the leg. In contrast, non-displaced fractures do not have much impact on your leg length.

While leg shortening and rotation are common signs of a hip fracture, you may consult Dr. Charles Ruotolo for imaging tests. These tests will help confirm the fracture, assess its severity, and determine the most effective treatment plan to prevent complications, such as blood clots.

What Are the Most Common Types of Hip Fractures?

Common types of hip fractures are femoral neck, intertrochanteric, and subtrochanteric fractures, each affecting a specific part of the upper femur. These fractures pose serious risks for elderly patients, often causing immobility, chronic pain, and increased mortality, making rapid diagnosis and targeted treatment essential.

Here’s how each type of hip fracture impacts the femur and leads to injury:

Femoral Neck Fractures

These fractures occur just below the femoral head. The bone in this narrow region is prone to fractures under stress because it bears the body’s weight and has a limited blood supply. When damage occurs, it can cut off the blood supply to the femoral head, leading to avascular necrosis (bone death).

Intertrochanteric Fractures

Intertrochanteric hip fractures occur between the greater and lesser trochanters. The fracture line disrupts the femur’s natural load-bearing axis, weakening the structural integrity. As a result, muscles attached to the trochanters can pull the bone fragments apart.

Subtrochanteric Fractures

This part of the femur is located just below the trochanters and is under high stress from body weight or muscle forces. Trauma or osteoporosis can cause multiple breaks here, often creating unstable fractures that resist natural healing without internal fixation.

How Does a Stress Fracture Differ From a Break?

A stress fracture is a small, hairline crack in a bone caused by repetitive force or overuse. In contrast, a break (acute fracture) usually occurs suddenly due to a significant injury or trauma. Other than that, stress fractures develop gradually, whereas breaks often cause immediate pain, swelling, and loss of function.

Moreover, stress fractures are most common in weight-bearing bones such as the foot, ankle, shin, and hip, particularly among athletes, runners, and individuals who suddenly increase physical activity. Symptoms of these fractures typically start as mild discomfort that worsens with movement and improves with rest. In contrast, a traditional bone break often results from falls, accidents, or direct impacts and may cause severe pain, visible deformity, bruising, and difficulty using the affected limb.

Diagnosis for both conditions usually involves imaging tests, but stress fractures may not appear on standard X-rays in the early stages, requiring MRI or bone scans for confirmation. Additionally, treatment depends on the severity of the injury, ranging from rest and activity modification for stress fractures to casting, bracing, or surgery for more serious bone breaks.

How Do Doctors Diagnose a Hip Fracture?

Dr. Charles Ruotolo, our hip surgeon, diagnoses a fracture through a combination of physical examination and imaging tests. He first observes your symptoms, such as severe groin pain, inability to bear weight, and a shortened leg that naturally turns outward. After that, he confirms the fracture using X-rays or, in complex cases, magnetic resonance imaging or CT scans to detect soft-tissue damage.

Beyond this, Dr. Charles Ruotolo also evaluates the mechanism of injury, patient age, and medical history. He may perform the following lab tests to identify underlying conditions that weaken bones:

• Complete Blood Count (CBC): Helps detect anemia, infection, or other blood-related conditions that may affect recovery.
• Serum Calcium Test: Measures calcium levels, which are essential for bone strength and health.
• Vitamin D Test: Identifies vitamin D deficiency, a common contributor to weakened bones and fractures.
• Bone Density Testing (DEXA Scan): Assesses bone density and helps diagnose osteoporosis.
• Parathyroid Hormone (PTH) Test: Evaluates hormone levels that regulate calcium and bone metabolism.
• Phosphorus Test: Checks phosphorus levels, another key mineral involved in bone formation.
• Thyroid Function Tests: Detect thyroid disorders that can accelerate bone loss.
• Kidney Function Tests: Determine whether kidney disease is affecting mineral balance and bone health.
• Alkaline Phosphatase (ALP) Test: Measures an enzyme associated with bone growth and turnover.
• Bone Turnover Marker Tests: Evaluate the rate of bone breakdown and formation, helping identify metabolic bone disorders.

After reviewing test results, Dr. Charles Ruotolo creates a treatment plan according to your fracture’s type and severity. These tests also help reduce complications such as immobility, blood clots, and chronic pain during surgical procedures. If you have severe hip pain after a fall, schedule your consultation today for an accurate diagnosis.

Which Medications Can Help Manage Hip Fracture Pain?

Medications used to manage hip fracture pain often include acetaminophen, short-term opioids, and carefully selected NSAIDs or COX-2 inhibitors. Some healthcare providers may also suggest local anesthetic nerve blocks to reduce severe pain, improve comfort, and limit opioid use before or after surgery.

Here’s how these medications and injections work to reduce hip fracture pain:

1. Acetaminophen is commonly used for mild-to-moderate pain, while opioids are usually reserved for severe pain.
2. Opioids are highly effective, but they are carefully monitored, especially in older adults, due to risks of drowsiness and constipation.
3. NSAIDs such as ibuprofen, naproxen, celecoxib, or meloxicam are used to reduce swelling and soreness. However, they are used cautiously in older patients due to kidney or gastrointestinal risks.
4. Fascia-Iliaca or Femoral blocks are injected into the groin area to numb the nerves surrounding the hip. They provide excellent pain relief while reducing the risk of opioid-related confusion.

How Do Doctors Fix a Broken Hip?

Dr. Charles Ruotolo, our orthopedic surgeon, repairs a broken hip with surgery, either by securing the fractured bone or by replacing part or all of the hip joint. The best method depends on the fracture location, bone strength, blood supply, age, health, and mobility goals.

If the bones can be properly aligned, he performs internal fixation (or “hip pinning”). During surgical repair, he makes an incision to realign the bone fragments and secures them in place with specialized metal screws, plates, rods, or nails. This method is only suitable for younger adults or patients with minimally displaced fractures. In contrast, if the bone is severely broken or if the blood supply to the hip joint is compromised, repairing it may result in bone death. In these cases, he either replaces only the “ball” portion or both the damaged “ball” and the “socket” with artificial prosthetic components.

When Is a Total Hip Replacement Recommended?

Dr. Charles Ruotolo may recommend total hip replacement when severe joint damage causes persistent pain and limits daily activities. He also advises this broken hip surgery when non-operative treatments such as targeted exercises, anti-inflammatory medications, and walking aids have failed to provide adequate relief.

Moreover, he may recommend a total hip replacement if you experience loss of hip movements, which makes simple activities difficult. Similarly, if you have advanced osteoarthritis, rheumatoid arthritis, avascular necrosis, or deformity that damages the ball-and-socket joint, he may advise total hip replacement.

How Long Does It Take to Recover From a Hip Injury?

Minor hip strains take 2 to 6 weeks to heal, while severe fractures or joint replacements require 6 to 12 months for a full recovery. Similarly, partial tears of hip muscles often require 3 to 12 weeks of restriction on heavy lifting or high-impact activities.

In fact, the NCBI study reported that complete tears require 8.9 weeks to recover with non-operative treatment and 14.2 weeks after surgical repair. For major hip interventions (like joint replacements or severe fractures), recovery progresses through the following stages:

• 0-6 Weeks: Focus on stabilizing the joint, protecting the incision, and beginning gentle range-of-motion exercises. Most patients start walking with assistive devices (crutches or a walker) within 24 hours of surgery.
• 6-12 Weeks: Targeted exercises focus on gait correction and strengthening. Many patients can return to desk jobs, driving, and low-impact exercises like swimming.
• 3-12 Months: The long-term phase focuses on rebuilding full muscle strength and joint flexibility. Most major improvements in pain and function happen during this time.

How Can You Reduce the Risk of Future Hip Fractures?

You should treat osteoporosis early, strengthen muscles, reassess medications for suitability, and correct vision problems to reduce the risk of future hip fractures. According to an NIH study, in-hospital osteoporosis treatment after hip fracture was also associated with a 48% reduction in subsequent hip fracture risk and a 29% reduction in mortality.

You should also take a diet rich in enough calcium (dairy products, sardines, broccoli) and vitamin D. However, if you cannot consume enough of these essential nutrients, consult your doctor about taking daily vitamin and mineral supplements. You can also participate in exercises that specifically target muscle strength and stability. For example, Tai Chi and yoga are highly recommended for reducing fall risk. Similarly, sustained intentional walking and light resistance training can help maintain or improve bone density.

In addition, quit smoking and limit alcohol consumption, as both can accelerate bone loss and impair balance. You should also wear padded hip protectors designed to absorb shock and redirect impact in the event of a fall.

Get Immediate Hip Fracture Treatment at Total Orthopedics & Sports Medicine in East Meadow!

A hip fracture can cause severe pain and make it difficult for you to move, stand, or walk without assistance. You may notice sharp pain in your hip, groin, thigh, or lower back. Besides that, swelling, bruising, weakness, or difficulty rotating your leg can make basic movements painful.

At Total Orthopedics and Sports Medicine, Dr. Charles Ruotolo, a member of the American College of Sports Medicine, reviews your symptoms to identify the severity of a fracture. Based on your diagnosis, he may recommend protected weight-bearing with assistive devices, medications, or injections. In cases of serious fractures, he performs surgical repair. Visit us at 2339 Hempstead Turnpike, East Meadow, NY 11554, or call 855-321-6784 to get a personalized treatment.

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