Hip Fractures: What to Know About Prevention, Treatment and Recovery
Did you know that 22% of people who suffer a hip fracture will die within a year?
While grim, this statistic demonstrates that hip fractures are among the most serious injuries affecting older adults, often leading to loss of independence, reduced quality of life and an increased risk of death.
The good news is that hip fractures can be prevented, and even if they do occur, they can be treated effectively with surgery and physical therapy.
A recent review published in JAMA(opens in new tab) examined the latest evidence on who is at risk for hip fractures, how they're treated, and what can be done to prevent them.
Joy Tsai, MD, a physician-investigator in the Division of Endocrinology at Mass General Brigham, is senior author of the review.
What is a hip fracture?
Joy Tsai, MD
Every year, more than 14 million people worldwide—and about 280,000 people in the United States—experience a hip fracture, which is a break in the upper part of the thigh bone (femur) near the hip joint.
Most hip fractures occur after a fall and are classified into two main categories–intracapsular fractures (inside the joint capsule) and extracapsular fractures (outside the capsule).
Symptoms include severe hip pain and difficulty walking. The affected leg may appear shortened or turned outward.
Diagnosis is typically done with a standard X-ray, which can identify most fractures.
Most patients require surgery as part of treatment, which typically involves either stabilizing the fracture with screws, rods or pins, or replacing part or all of the hip joint.
Why are hip fractures such a concern?
Hip fractures can have life-changing consequences. As mentioned above, the median one-year death rate after a hip fracture is approximately 22% worldwide.
Many patients also experience long-term mobility challenges after a fracture, and only about one-half to two-thirds of patients regain their pre-fracture ability to perform basic daily activities within six months.
What are the top risk factors?
Age is the strongest risk factor, as hip fractures become much more common after age 70. Sex is another factor, with women experiencing higher rates than men, largely because bone loss accelerates after menopause and women are more likely to fall in older age.
Other important risk factors include:
- Osteoporosis or low bone mineral density
- Previous fractures or a family history of hip fracture
- Smoking
- Excessive alcohol use
- Low physical activity
- Poor nutrition
- Loss of muscle strength and balance
- Poor vision
- Taking certain medications, including antidepressants, sedatives, and corticosteroids
Doctors often use risk-assessment tools such as FRAX(opens in new tab), which estimates a person's 10-year risk of hip fracture based on factors including age, sex, body weight, smoking history, previous fractures and bone density measurements.
Can hip fractures be prevented?
In many cases, yes. Prevention focuses on both strengthening bones and reducing falls.
Tactics for preventing hip fractures include participating in regular physical activity and strength training, maintaining adequate calcium and vitamin D intake, treating osteoporosis, reviewing medications that may increase fall risk, addressing vision problems and improving home safety by removing tripping hazards.
What role does rehabilitation play?
Rehabilitation is a critical part of recovery. Physical therapy often begins shortly after surgery and focuses on walking safely, improving balance, building strength, climbing stairs and restoring independence in daily activities.
How is your research helping to advance the field?
My research focuses on optimizing the use of bone-strengthening medications available for use in clinic.
We now know that the order of medications makes a difference and our work explores different sequences or combinations of medications to help patients at highest risk of fracture.
Seeing my patients suffer a hip fracture and wish they could regain their independence at home is a powerful motivator to educate them about the importance of fracture prevention and timely treatment to reduce the risk of recurrent fractures after a hip fracture.
What is the bottom line?
Hip fractures are common, serious injuries that primarily affect older adults. While they can lead to disability and increased mortality, many risk factors are preventable or treatable.
Maintaining strong bones, preventing falls, promptly repairing fractures when they occur, participating in rehabilitation, and treating osteoporosis can all help improve outcomes and reduce the likelihood of future fractures.
See Dr. Tsai Speak on Bone Health and Menopause(opens in new tab)(opens in new tab)
Dr. Tsai will be one of three panelists speaking during the public outreach session as part of the American Society for Bone and Mineral Research's annual meeting in Boston this fall. Learn more and register for free at the link below.
An Owner’s Manual for the Skeleton: Protecting Your Bones Through Movement, Medicine, and Menopause
Saturday, October 10, 2026
4:30–7:00 p.m.
John B. Hynes Convention Center in Boston, Massachusetts