Fractures of the Hip and Pelvis

Hip

The hip is a ball-and-socket joint. The ball, at the top of your femur (thighbone) is called the femoral head. The socket, called the acetabulum, is a part of your pelvis. The ball moves in the socket, allowing your leg to rotate and move forward, backward and sideways. A hip fracture is a break in either the upper portion of the femur or of the pelvis.

Femoral hip fractures

The term "broken hip" usually refers to a fracture of the ball side of the hip joint, that is, a break in the upper femur, generally in one of three areas:

• the femoral neck (just below the femoral head) – called an intracapsular fracture (most common)
• immediately below the femoral neck – called an intertrochanteric fracture
• the upper femoral shaft below the femoral neck – called a subtrochanteric fracture (least common)

Hip fractures frequently occur in the elderly, people affected by disease, or from direct trauma. Femoral hip fractures can be treated relatively easily, with our without surgery, depending on the severity of the injury.

Pelvic and acetabular hip fractures

A fracture of the acetabulum or other portion of the pelvis is often a more serious injury that requires prompt surgery (in some cases, multiple surgeries). These types of breaks are often the result of high-impact trauma such as a car vehicle accident or a bad fall. However, they can occur during a lower-impact fall, primarily in older adults who have fragile bones due to osteoporosis.

In fractures of this type, the femoral head is often driven through the acetabulum because of the impact of the fall or accident. If the fracture causes the femoral head to pop outside the acetabulum, this is known as a dislocated hip.

Treating acetabular fractures is complex because this section of bone is very close to:

• the major blood vessels to the legs
• the sciatic nerve (the major nerve that arises from the lower spine and provides sensation and movement to the leg and foot)
• the intestines, the ureter and the bladder