A hip fracture is a break in the upper part of the femur (thighbone), specifically near the hip joint. This area, known as the proximal femur, includes the neck and the ball that fits into the pelvis socket. While a severe break makes walking immediately impossible, the ability to bear weight varies based on the fracture’s location and nature. Whether a person can walk depends entirely on the stability of the fractured bone fragments. It is possible, though dangerous, to walk with certain types of hip fractures, making recognition of subtle signs important.
Why Walking Ability Depends on Fracture Type
The mechanical stability of the bone directly determines whether a person can walk after the injury. In a highly unstable injury, known as a displaced fracture, the bone fragments have separated and shifted out of alignment. This displacement causes immediate, excruciating pain and prevents the leg from supporting any weight, making walking or standing impossible. The structural integrity of the joint is compromised, signaling a serious injury.
In contrast, a non-displaced fracture, sometimes called a hairline or impacted fracture, can allow for limited mobility. The bone is broken, but the fragments are jammed together and remain in good alignment. These impacted fractures provide enough temporary stability that the patient might mistakenly believe they have only a severe bruise or sprain. Walking with this type of break is hazardous because the temporary stability can fail, causing the fracture to suddenly displace.
Fractures of the femoral neck, the area just below the ball of the joint, are prone to this variability. A displaced femoral neck fracture often compromises the blood supply to the head of the femur, making prompt surgical repair essential. Intertrochanteric fractures, which occur slightly lower down, tend to have better blood supply but still require surgical stabilization to heal properly. The mechanical environment dictates the possibility of movement, but even limited weight-bearing should be considered a serious warning sign.
Recognizing Symptoms Beyond Mobility
Even if a person can walk or stand with a hip injury, distinct symptoms point toward a fracture rather than a less severe soft tissue injury. A common indicator is persistent pain located deep in the groin, which worsens significantly with movement or weight-bearing. This groin pain is often referred pain from the hip joint and is present even when the patient is resting. A visible sign of a displaced fracture is a noticeable shortening of the injured leg compared to the uninjured side, which occurs because the muscles pull the broken fragments upward.
The injured leg may also appear turned outward, or externally rotated, in a resting position. A medical professional may find that any attempt to gently rotate the leg inward or outward causes a sharp increase in pain. While bruising and swelling occur with many injuries, in a fracture, these signs often develop around the hip or thigh hours or even a day after the initial trauma. The pain with a hip fracture is acute, meaning it is sudden and severe, and it will not subside with rest like a minor muscle strain.
Immediate Actions and Diagnosis
If a hip fracture is suspected, regardless of the person’s ability to walk, the immediate action is to call for emergency medical services. Putting any further weight on the injured leg must be avoided completely, as this risks converting a stable, non-displaced fracture into a displaced one. Until medical help arrives, the person should be kept comfortable and remain still to prevent unnecessary movement of the limb. Nearly all hip fractures require surgical intervention to ensure proper healing and prevent complications.
Upon arrival at the hospital, the initial diagnostic step is typically a series of X-rays of the pelvis and hip to visualize the bone structure. These images usually confirm the diagnosis and classify the type of fracture. If X-rays appear normal but suspicion remains due to persistent pain and inability to bear weight, a more sensitive imaging test is necessary. In these cases, a CT scan or magnetic resonance imaging (MRI) scan is used to identify occult fractures, which are subtle breaks not visible on the standard X-ray. The definitive treatment for most hip fractures is surgery, often performed within 24 to 48 hours, followed by a comprehensive rehabilitation program.