A broken hip, or hip fracture, is a serious injury involving a break in the upper part of the thigh bone (femur) near the hip joint. This injury nearly always requires immediate surgical intervention to stabilize the bone and prevent severe complications. While surgery mends the break, the total time to regain full function is complex and highly individualized. Recovery is a phased process, moving from acute medical care to structured physical rehabilitation.
Surgical Treatment and Acute Recovery Phase
The immediate medical response focuses on stabilizing the patient and preparing for surgery, generally performed within 24 to 48 hours to minimize complications. The specific surgical approach depends heavily on the fracture location and severity. Two main categories of surgery are used: internal fixation and hip replacement.
Internal fixation uses metal screws, plates, or rods to hold bone fragments together while they heal naturally, and is often used for less severe fractures. The second option is arthroplasty, or hip replacement, which may be a hemiarthroplasty (replacing only the ball) or a total hip replacement (replacing both the ball and socket). Replacement is typically chosen for severe breaks near the joint that compromise blood flow, or for patients with pre-existing joint disease.
Following the procedure, the acute recovery phase focuses on pain management and early mobilization. Physical therapy typically begins within 24 hours to prevent muscle loss and complications like blood clots. The average hospital stay is between two to seven days, depending on the patient’s stability and overall health. This phase concludes when the patient is medically stable enough to be discharged to the next level of care, such as a rehabilitation facility or home.
Structured Rehabilitation and Mobility Milestones
After hospital discharge, the patient enters the structured rehabilitation phase. Patients often transition to an inpatient rehabilitation facility for intensive therapy, typically lasting between one to three weeks. In this setting, physical and occupational therapists work to improve strength, mobility, and the ability to perform basic self-care tasks.
Following inpatient rehabilitation, or directly after discharge, the patient continues with outpatient or home health therapy for six weeks to three months. This phase focuses on gradually reducing reliance on assistive devices, such as progressing from a walker to a cane. The ability to bear full weight varies; hip replacement patients may bear weight sooner, while those with internal fixation require limited weight-bearing to allow bone healing.
A major milestone is regaining functional independence, which involves managing activities of daily living (ADLs) like dressing and bathing without assistance. Significant functional recovery is commonly achieved within three to six months after surgery. Regaining strength, balance, and endurance may continue for up to a year, with individuals often seeing mobility improvements throughout this period.
Key Variables Influencing Full Recovery
The timeline for full recovery is highly individualized and can be significantly altered by several factors. A patient’s age is a major determinant, as older individuals often have a slower healing process and a higher risk of not returning to their pre-injury mobility level. The patient’s health status prior to the fracture also plays a substantial role.
Pre-existing conditions, or comorbidities, such as diabetes, osteoporosis, and heart disease, can slow healing and increase the risk of complications. A patient’s cognitive status, including dementia, can negatively affect recovery by making compliance with physical therapy difficult. Compliance with the prescribed physical therapy regimen is the most controllable factor, directly influencing the speed and degree of strength and mobility regained.
Post-operative complications can also extend the recovery period beyond the expected range. Issues like surgical site infection, blood clots, or a non-union (failure of the fracture to heal) require additional medical intervention, setting back rehabilitation. Poor nutritional status can also impede the body’s ability to repair bone and muscle tissue, slowing the entire recovery process.