Hip Fracture, Dislocation & Femoral Injury
Recognise occult hip injury and combine timely treatment with medical and functional recovery.
Quick revision ↓ Medical Dictionary
01Assess hip pain
An older adult unable to bear weight after a fall may have a hip fracture even without a dramatic deformity. Examine gently, assess analgesia needs and document baseline mobility and cognition. If radiographs are negative but suspicion persists, arrange appropriate further imaging rather than declaring the injury excluded.
02Early coordinated care
Hip-fracture care combines prompt orthopaedic assessment with medical optimisation, analgesia, hydration and pressure care. Address reversible problems without unnecessary delay to surgery. Delirium risk, anticoagulation and comorbidity require coordinated planning; the pathway aims to restore function as well as treat the bone.
03Procedure choice
Fracture location and displacement influence fixation or arthroplasty choices, along with patient function and health. Intracapsular injuries can threaten femoral-head blood supply. Explain treatment goals and risks individually instead of suggesting that one procedure suits every hip fracture.
04Hip dislocation
Traumatic hip dislocation is urgent and may accompany acetabular or femoral-head injury. Assess sciatic nerve function and distal perfusion. Reduction should be undertaken promptly by an appropriately prepared team, followed by reassessment and imaging; delay can increase complications including osteonecrosis.
05Femoral shaft and rehabilitation
A shaft fracture can produce significant blood loss and coexist with other high-energy injuries. Stabilise through the trauma pathway and monitor the whole patient. After definitive care, communicate mobilisation and weight-bearing instructions, support rehabilitation and assess falls and bone health where a fragility mechanism is likely.
High-Yield Revision
- Negative initial films do not exclude every hip fracture.
- Hip-fracture care needs medical and rehabilitation coordination.
- Femoral fractures can conceal substantial blood loss.
Common Pitfalls
- Discharging persistent inability to bear weight without a plan.
- Delaying urgent hip-dislocation management for routine scheduling.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.