Important: This page provides general information only. It is not a substitute for professional medical advice, diagnosis, or treatment. If you have concerns about your bone health, please speak to your doctor.
Hip Fractures & Broken Hips in Older People
A hip fracture is the most serious type of fragility fracture. It requires emergency surgery, carries significant risks, and can have a profound impact on independence and quality of life. In Ireland, hip fractures place a major burden on both individuals and the healthcare system.
~3,600
hip fractures in Ireland each year
20–30%
of older adults die within 12 months of a hip fracture
50%
of hip fracture survivors do not regain previous level of function
Symptoms of a Broken Hip
After a fall in an older person, the signs that point to a hip fracture are:
- Being unable to stand or bear weight on the affected leg
- Pain in the groin or outer hip, often worse on any attempt to move or rotate the leg
- Pain referred to the knee or thigh — a common source of missed diagnosis
- The leg appearing shorter and turned outward
- Limited bruising or swelling — the absence of a dramatic-looking injury does not rule a fracture out
Someone can walk on a broken hip. Incomplete and impacted fractures sometimes allow a person to keep going, painfully, for days — and continuing to walk risks the fracture displacing. Any older person with persistent groin, hip or knee pain after a fall needs an X-ray, whether or not they can walk on it.
Why Are Hip Fractures So Serious?
Unlike most fractures, hip fractures in older adults are associated with major systemic consequences:
- Immediate complications: Blood clots (deep vein thrombosis, pulmonary embolism), pneumonia, urinary tract infections, pressure sores — all related to sudden immobility
- High mortality: Up to 20–30% of older adults who sustain a hip fracture in Ireland die within the following 12 months. Men have a higher mortality rate than women.
- Loss of independence: Many people who could live independently before their hip fracture are unable to return home afterwards, requiring ongoing residential or nursing home care
- Pain and functional limitation: Even for those who recover well, chronic pain and reduced mobility are common
What Happens When Someone Has a Hip Fracture?
Emergency Presentation
Hip fractures are medical emergencies. Symptoms include:
- Sudden, severe pain in the hip or groin after a fall
- Inability to bear weight on the affected leg
- The leg may appear shortened and rotated outward
If you suspect someone has a hip fracture, call 999 / 112 immediately. Do not attempt to move the person.
Surgery
Almost all hip fractures in older adults require surgery. The type of surgery depends on the location and pattern of the fracture:
- Internal fixation (using metal screws, plates, or nails) — used to hold the broken bone in place while it heals; typically for fractures that have not displaced significantly
- Hemi-arthroplasty — replacement of the femoral head (ball of the hip joint) with a prosthesis; used when the blood supply to the bone head may be compromised
- Total hip replacement — replacement of both the ball and socket; may be considered in certain fracture types, particularly in more active, younger older adults
Irish and international guidelines recommend that surgery should take place within 24–48 hours of admission to minimise complications. Delays to surgery are associated with higher mortality and worse outcomes.
Rehabilitation
Rehabilitation begins as soon as possible after surgery — typically the morning after:
- Day 1 post-surgery: Physiotherapist helps the patient sit up and start to mobilise (stand/walk with support)
- Hospital: Progressive walking, stair practice, exercises to restore strength and confidence
- Discharge: May go home with community physiotherapy support, or to an inpatient rehabilitation facility or nursing home
- Outpatient rehabilitation: Continues for weeks to months after discharge; goals include returning to independent walking, daily activities, and reducing fall risk
Secondary Prevention After Hip Fracture
After a hip fracture, it is essential that bone density is assessed and appropriate treatment started to prevent a second fracture. In Ireland, some hospitals have Fracture Liaison Services (FLS) to coordinate this automatically. If you are not referred, ask specifically:
- “Has my bone density been assessed or will it be arranged?”
- “Should I be starting bone-protective medication?”
- “Will I receive a referral to a Fracture Liaison Service?”
Read more on our Secondary Fracture Prevention page.
Before discharge, bone health should be assessed and treatment started where appropriate. See Fracture Liaison Services for what should happen, and how to ask for it if it does not.
For Family Members and Carers
If your family member has had a hip fracture, your role in their recovery is important:
- Attend rehabilitation sessions where possible — understanding the exercises helps you support them at home
- Help ensure the home is made safe before discharge (grab rails, removal of trip hazards, lighting)
- Ask the hospital social work team about any entitlement to home care support packages through the HSE
- Encourage and assist with prescribed exercises, but do not push beyond what has been recommended
- Monitor for signs of depression or excessive fear of activity, which are common after hip fractures
Hip Fractures: Common Questions
What are the symptoms of a broken hip?
The classic picture is inability to stand or walk after a fall, pain in the groin or outer hip that worsens on any attempt to move the leg, and the affected leg looking shorter and turned outward. Bruising and swelling may be limited. Importantly, some hip fractures are incomplete, and a person can still walk on a cracked hip while complaining of persistent groin pain — if pain continues after a fall, it needs an X-ray even if they are walking.
How serious is a broken hip in the elderly?
It is the most serious of all fragility fractures. Almost all hip fractures require surgery, most people spend weeks in hospital and rehabilitation, and a substantial proportion never return to their previous level of independence. Around 3,600 hip fractures occur in Ireland each year. This is why prevention and prompt treatment matter so much.
How long does it take to recover from a broken hip?
Surgery usually happens within 48 hours and people are helped to stand the day after. Hospital stay is commonly one to two weeks, followed by weeks of rehabilitation. Most functional recovery happens in the first three to six months, and improvement can continue for a year. Recovery is generally slower and less complete in people who were already frail or had limited mobility beforehand.
Why do people die after a hip fracture?
Rarely from the broken bone itself. Deaths follow from the consequences of immobility and major surgery in an older person who often already has other conditions — chest infections, blood clots, pressure sores, delirium, and the loss of muscle and appetite that comes with prolonged bed rest. This is exactly why surgery is done quickly and why people are got out of bed the next day rather than being rested.
Can you walk with a broken hip?
Usually not, but not always. Most people with a displaced hip fracture cannot bear weight at all. However, an incomplete or impacted fracture can allow someone to keep walking, painfully, for days. Continuing to walk on it risks the fracture displacing. Any older person with persistent groin, hip or knee pain after a fall should be X-rayed, regardless of whether they can walk.
What happens after hip fracture surgery?
You should be helped to stand and take steps the day after surgery, because early mobilisation reduces complications. Physiotherapy starts immediately and continues through rehabilitation. Before discharge you should also be assessed for osteoporosis and falls risk, and started on bone treatment where appropriate — a hip fracture is a clear signal that the next fracture is likely unless something changes.
Talk to Your Doctor
If you or a family member have had a hip fracture, ensure that bone density assessment and secondary fracture prevention treatment are arranged before or after discharge. Ask the hospital team or your doctor.
You can say: “I'd like to discuss my bone health and whether I should have a DXA scan.”
Questions to Ask Your DoctorLast reviewed: February 2026 — FragilityFracture.ie Editorial Team