Hip fractures are serious injuries, particularly for older adults. Each year, over 300,000 adults aged 65 and older are hospitalized in the U.S. due to hip fractures, with falls being the primary cause. This type of injury can lead to a substantial loss of independence and an increased risk of other health complications. Recovery involves various stages of healing and rehabilitation.
General Healing Timeline
Healing from a hip fracture involves two distinct phases: bone healing and functional recovery. Bone mending typically shows signs within 10 to 12 weeks. However, regaining strength and mobility takes a much longer period.
Functional recovery, which involves restoring the ability to perform daily activities, generally takes at least six months to a year. A full return to prior activity levels could take a year or more. Individual recovery times can vary considerably.
Key Factors Affecting Healing
Several elements influence how quickly and completely a hip fracture heals. A person’s age and overall health play a large role, as older adults often have reduced bone density, making bones more brittle and healing slower. Pre-existing health issues such as diabetes, cardiovascular problems, or vascular disease can also hinder the body’s ability to repair itself.
The specific type and severity of the fracture also impact recovery. Fractures closer to the hip joint, like those in the femoral neck, may disrupt blood supply and increase the risk of complications, potentially prolonging healing. Displaced fractures, where bone fragments are moved out of alignment, require more complex interventions and longer recovery periods than non-displaced fractures.
While most hip fractures require surgery, the chosen treatment method affects the timeline. Post-surgical complications, such as infection, blood clots, or avascular necrosis (bone tissue death due to lack of blood supply), can significantly extend the healing process. Adherence to rehabilitation protocols is important, as consistent physical therapy helps rebuild strength and mobility. Nutrition and lifestyle choices, including a diet rich in calcium and vitamin D, and avoiding smoking, directly support bone health and healing.
The Recovery Process
The recovery journey after a hip fracture begins immediately following the injury with prompt surgical intervention. Common surgical procedures include internal fixation, using screws or plates to hold the bone fragments, or a hemi-arthroplasty (partial hip replacement) or total hip replacement, depending on the fracture’s location and the patient’s condition. Surgery is performed within 24 to 48 hours to minimize complications.
After surgery, patients remain in the hospital for a few days for acute care, focusing on pain management and monitoring for complications like blood clots or infections. Pain relief is managed with a scheduled regimen of medication to facilitate early movement. Early mobilization is encouraged, with physical therapy beginning within 24 hours of surgery, starting with gentle bed exercises to improve circulation and prevent stiffness.
Patients then progress to sitting, standing, and taking their first steps, with assistance from a walker or crutches. This early movement helps prevent muscle atrophy and other complications associated with prolonged bed rest. As recovery continues, rehabilitation involves both physical and occupational therapy to build strength, balance, and range of motion. Rehabilitation exercises gradually increase in difficulty, moving from simple chair exercises to stepping, walking, and stair climbing.
Upon discharge from the hospital, which occurs after two to seven days, recovery continues at home or in an inpatient rehabilitation facility. Home recovery involves adapting the living environment for safety, using assistive devices, and consistently performing prescribed exercises. Outpatient therapy may last several weeks to months, focusing on continued improvement in balance and mobility.
Expected Milestones and Long-Term Outlook
As individuals progress through hip fracture recovery, several milestones can be expected. In the short term, within the first few weeks to months, the focus is on regaining independence in basic self-care activities, such as dressing, bathing, and getting in and out of bed. Patients transition from a walker to crutches or a cane as their balance and strength improve, with the goal of walking independently. Achieving over 150 steps per day in the first month and 425 steps per day by the third month are associated with functional improvement.
The long-term outlook for hip fracture recovery involves a gradual return to more complex activities. Many individuals can resume light household chores and short outings within 6 to 12 weeks, with driving potentially resuming around 6 to 8 weeks after medical clearance. Full functional recovery, including a return to activities like golf or cycling, may take six months or longer, particularly after a total hip replacement. While many patients regain a significant level of independence, some may experience long-term limitations or require ongoing support, with about half of individuals not fully regaining their pre-injury level of mobility. Continued exercise, balance training, and fall prevention strategies remain important to maintain gains and reduce the risk of future fractures.