Hip Fracture in Older Adults: Surgery, Recovery & Preventing Falls

Quick answer

A hip fracture in an older adult usually follows a simple fall and usually means the bones have been weakened by osteoporosis. It almost always needs an operation, ideally on the day of admission or the next day, followed by getting up and moving as soon as possible. Recovery takes months and needs a plan for strength, bone health and preventing further falls. Strength and balance exercise reduces the rate of falls by about a quarter.

Written and medically reviewed by

Dr Udit Vinayak M.S. Orth (Gold Medalist)

Dip. FIFA, A.O Fellow, FIJR

Trauma, Sports Medicine & Joint Replacement Surgeon, VinayakM Health

Last reviewed:

September 27, 2026

Overview

Hip fractures are among the most serious injuries in older age. They happen at the top of the thigh bone, either inside the hip joint capsule (intracapsular) or just below it (extracapsular), and the type decides the operation: fixing the bone with screws, a plate or a nail, or replacing part or all of the hip joint.

Most people with a hip fracture have osteoporosis, often undiagnosed until the fracture. A hip fracture is therefore also a warning: the next fracture can be prevented with bone treatment and fall prevention.

Day 0 to 1SurgeryAn operation on the day of admission or the next day, with good pain control.

Day 1Moving againGetting out of bed and standing with help, usually the day after surgery.

Weeks to monthsRehabilitationWalking, strength and balance, with a plan for the home.

OngoingPreventing the nextBone health treatment and a falls-prevention plan.

The recovery pathway after a hip fracture, following UK NICE guidance.

Symptoms & signs

Pain in the groin or outer hip after a fall.
Inability to stand or walk, or walking only with great pain.
The leg may look shorter and turned outwards.
Some people can still walk after a small crack in the bone, so pain in the groin after a fall always needs checking.

Causes & risk factors

Osteoporosis: bones that break from a fall from standing height.
Falls: linked to weak leg muscles, poor balance, dizziness, poor eyesight, some medicines (particularly sleeping tablets and blood pressure medicines), and hazards at home.
Age, low body weight, previous fractures, long-term steroid use, and conditions that affect balance, such as Parkinson’s disease or stroke.

When to see a doctor

After a fall, pain in the hip or groin with difficulty standing: seek hospital assessment the same day.
Hip or groin pain that persists after a fall, even if walking is possible: an X-ray, and sometimes MRI, is needed to rule out a hidden fracture.
A fall with a head injury, especially in someone taking blood thinners.
Repeated falls, dizziness or blackouts: these need medical assessment in their own right.

How it’s diagnosed

Hip fractures are confirmed with an X-ray. If the X-ray is normal but a fracture is still suspected, UK guidance recommends MRI, or CT if MRI is not available within 24 hours.

Once the fracture is treated, a bone health assessment should follow, often including a bone density scan and blood tests, to decide on osteoporosis treatment.

Treatment options

Surgery, ideally on the day of admission or the next day. Early surgery reduces complications from lying in bed.
Fixation (screws, plates or nails) or replacement of part or all of the joint, depending on the fracture type and the person’s fitness. For fit, independent people with some fractures, a total hip replacement may be offered.
Early mobilisation: standing and walking with help from the day after surgery.
Rehabilitation: strength and balance work continued for months, not just days.
Bone treatment: medicines to strengthen bone, calcium and vitamin D where needed, to prevent the next fracture.

Recovery is not the same for everyone. Many people regain much of their independence, but some do not return to their previous level of walking, which is why rehabilitation and fall prevention matter so much.

How VinayakM helps

At VinayakM, the months after a hip fracture are where we can help most, working alongside the hospital team that carried out the surgery.

Continued rehabilitation with our physiotherapist: strength, balance and confidence walking.
A review of bone health, medicines and fall risks, with an orthopaedic opinion where needed.
Nutrition support with our dietitian: protein, calcium and vitamin D for healing and muscle strength.

Book your first review Call +91 92171 75397

Prevention & self-care

Falls prevention is the most effective way to prevent hip fractures. A large Cochrane review found that exercise reduces the rate of falls in older people living at home by about 23%, with balance and functional exercises particularly effective.

Strength and balance exercise at least two to three times a week, progressed over months.
Medicine review: some sleeping tablets, sedatives and blood pressure medicines increase the risk of falls.
Eyesight checks, and care with multifocal glasses on stairs.
Home safety: night lights on the way to the bathroom, grab rails, removing loose rugs, and non-slip bathroom floors.
Footwear that fits well and grips, rather than loose slippers.
Bone health: protein, calcium, vitamin D and osteoporosis treatment where indicated.

Frequently asked questions

Why does a hip fracture need surgery so quickly?

Lying in bed with a broken hip causes pain and raises the risk of chest infections, blood clots, pressure sores and confusion. Surgery on the day of admission or the next day allows people to get up and move sooner.

Can someone in their 80s or 90s have surgery?

Yes. Most people, including the very elderly, are offered surgery because it is usually the best way to control pain and allow movement. The anaesthetic and surgical team assess each person carefully.

How long does recovery take?

The first weeks focus on walking safely; strength and confidence continue to improve for several months. Some people need a walking aid long term.

Will I need osteoporosis treatment?

Most people who break a hip from a simple fall have weak bones, so a bone health assessment and treatment to prevent another fracture are usually recommended.

What is the single best thing to prevent falls?

Regular strength and balance exercise, built up gradually over months, has the strongest evidence. It works best combined with a medicine review and a safer home.

References

National Institute for Health and Care Excellence (NICE). Hip fracture: management. Clinical guideline CG124. — https://www.nice.org.uk/guidance/cg124
National Institute for Health and Care Excellence (NICE). Falls: assessment and prevention in older people and in people 50 and over at higher risk. NICE guideline NG249. — https://www.nice.org.uk/guidance/ng249
Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for preventing falls in older people living in the community. Cochrane Database Syst Rev. 2019;1:CD012424. — https://doi.org/10.1002/14651858.CD012424.pub2
National Health Service (NHS). Broken hip. — https://www.nhs.uk/conditions/broken-hip/
National Health Service (NHS). Falls. — https://www.nhs.uk/conditions/falls/
Tornetta P III, Ricci WM, Ostrum RF, et al. (eds). Rockwood and Green’s Fractures in Adults. 9th ed. Wolters Kluwer; 2020. (textbook, consulted for background)
Pignolo RJ, Ahn J (eds). Fractures in the Elderly: A Guide to Practical Management. 2nd ed. Humana Press/Springer; 2018. (textbook, consulted for background)

Written in our own words. Textbooks were used as background reading and are cited; no text, figures or tables have been reproduced from them.

This page is for general information and education only. It is not a substitute for a consultation, diagnosis or treatment from a qualified clinician. If you have any of the red-flag symptoms above, seek medical care promptly.