Hip fractures generally affect older people, and are more frequent in women than in men. The hip is the only true ball-and-socket joint in the body, and the largest joint except for the knee. When porous and brittle, the thigh bones are most vulnerable to fracturing, especially in the top at the hip socket where this part of the femur (the ‘neck’) is the narrowest and yet has to carry the full load of the upper body.

Although fractures of the vertebrae can happen spontaneously, hip fractures are usually caused by an accident such as tripping over a small rug or slipping in the bath. Occasionally a hip fracture happens for no apparent reason, which triggers the thought – was the fall caused by a broken hip, or did the hip fracture because of the fall? A woman who has suffered a fractured hip on one side is twenty times more likely to have a subsequent fracture on the other.

Disabilities from such fractures are often the beginning of serious physical decline for the elderly: after leaving hospital, many osteoporotic patients are so afraid of falling that they lead very sedentary lives, depressed and full of despair at the disruption of their lives, remaining in nursing, homes until death. Statistics

can be frightening: 15 per cent of women die shortly after a hip fracture; almost 30 per cent die within a year; less than 50 per cent are able to return to normal life. A wrist fracture can be disabling for two months, but long-term disability is not uncommon. A hip fracture is one of the leading causes of accidental death among elderly white women, reducing life expectancy by 12 per cent. The cause of death is not the fracture itself, but the result of ailments associated with prolonged nursing home or hospital stays – pneumonia, blood clots, or a fat embolism.

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