Neck of Femur Fracture Fixation Rehabilitation
What is a neck of femur fracture?
The neck of the femur is the narrow section of bone that connects the rounded head of the femur (thigh bone) to its shaft, sitting just below the hip joint. A fracture in this area (commonly called a hip fracture) is one of the most significant orthopaedic injuries an older adult can sustain, and one of the most common reasons for emergency hospitalisation in people over 65.
In younger people, these fractures typically result from high-energy trauma such as motor vehicle accidents. In older adults they most commonly occur from a fall from standing height — a fall that might cause little more than bruising in a younger person, but can fracture bone that has been weakened by osteoporosis over many years. Hip fractures are a serious medical event, and rehabilitation after surgical fixation is central to whether a patient regains independence and returns home.
What surgery is involved?
Treatment is almost always surgical. The type of surgery depends on the specific location of the fracture and the condition of the bone. Fractures close to the femoral head are often treated with a hemiarthroplasty (partial hip replacement) or total hip replacement. Fractures further down the neck may be fixed with screws, a dynamic hip screw, or an intramedullary nail. Your physiotherapist will liaise with your surgical team to understand your specific procedure, the weight-bearing restrictions that apply, and any hip precautions you need to follow during recovery.
Why is physiotherapy so important after this surgery?
The research on this is clear — early physiotherapy after hip fracture surgery significantly reduces mortality risk, length of hospital stay, likelihood of requiring long-term care, and time to regaining independent mobility. The Australian Physiotherapy Association recommends physiotherapy beginning in hospital within the first 24 to 48 hours after surgery, with continued outpatient rehabilitation once discharged.
Without guided rehabilitation, the risks of complications including deconditioning, muscle wasting, falls, and loss of independence are significant. Many people make the mistake of assuming that rest is the priority after such a serious injury — in reality, safe, progressive movement is the most important thing you can do to protect your recovery.
What does rehabilitation involve?
Recovery from a NOF fracture is measured in months, not weeks. The timeline varies depending on your age, pre-fracture fitness and activity level, the type of surgery performed, and how your bone heals — but a realistic general framework looks like this.
In hospital and in the first weeks at home, the focus is on safe mobility — getting in and out of bed, chair transfers, and walking with a frame or crutches while respecting weight-bearing restrictions set by your surgeon. Falls prevention is a priority from the outset, and your physiotherapist will assess your home environment and advise on modifications or aids that reduce risk.
From one to three months, progressive strengthening of the hip, gluteal and quadriceps muscles begins in earnest. Balance and proprioception training is introduced as weight-bearing improves. Walking distance and confidence increase steadily. Most people are walking independently with a walking stick by eight to twelve weeks, though this varies considerably.
From three to six months, the focus shifts to restoring full function — returning to stairs, outdoor walking, driving (subject to clearance from your surgeon), and where relevant, returning to activities like gardening, golf or bowls. Exercise physiology plays an important role in this phase for patients who want to rebuild their overall fitness and strength beyond basic functional mobility.
For patients with underlying osteoporosis, addressing bone health is an essential component of long-term management and falls prevention. Our Exercise Physiologist Ash O'Regan has specific experience in osteoporosis management and our Balance and Bones exercise classes are designed specifically for this population.
Will I walk normally again?
This is the question most patients and their families want answered. For the majority of older adults who were independently mobile before their fracture, the goal of physiotherapy is to return them to that level of function. Many achieve it. The honest answer is that outcome depends significantly on pre-fracture fitness, the degree of bone health, the presence of other medical conditions, and how consistently rehabilitation is pursued. What is well-established is that physiotherapy-guided rehabilitation gives you the best possible chance of the best possible outcome.
If you are recently discharged from hospital following a NOF fracture, or are supporting a family member through recovery, please get in touch. Our team treats patients across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt, and we can arrange home visits or telehealth appointments for patients who cannot initially travel to the clinic. Call us on 07 3706 3407 or book online below.
Book your initial physiotherapy appointment
The neck of the femur is the narrow section of bone that connects the rounded head of the femur (thigh bone) to its shaft, sitting just below the hip joint. A fracture in this area (commonly called a hip fracture) is one of the most significant orthopaedic injuries an older adult can sustain, and one of the most common reasons for emergency hospitalisation in people over 65.
In younger people, these fractures typically result from high-energy trauma such as motor vehicle accidents. In older adults they most commonly occur from a fall from standing height — a fall that might cause little more than bruising in a younger person, but can fracture bone that has been weakened by osteoporosis over many years. Hip fractures are a serious medical event, and rehabilitation after surgical fixation is central to whether a patient regains independence and returns home.
What surgery is involved?
Treatment is almost always surgical. The type of surgery depends on the specific location of the fracture and the condition of the bone. Fractures close to the femoral head are often treated with a hemiarthroplasty (partial hip replacement) or total hip replacement. Fractures further down the neck may be fixed with screws, a dynamic hip screw, or an intramedullary nail. Your physiotherapist will liaise with your surgical team to understand your specific procedure, the weight-bearing restrictions that apply, and any hip precautions you need to follow during recovery.
Why is physiotherapy so important after this surgery?
The research on this is clear — early physiotherapy after hip fracture surgery significantly reduces mortality risk, length of hospital stay, likelihood of requiring long-term care, and time to regaining independent mobility. The Australian Physiotherapy Association recommends physiotherapy beginning in hospital within the first 24 to 48 hours after surgery, with continued outpatient rehabilitation once discharged.
Without guided rehabilitation, the risks of complications including deconditioning, muscle wasting, falls, and loss of independence are significant. Many people make the mistake of assuming that rest is the priority after such a serious injury — in reality, safe, progressive movement is the most important thing you can do to protect your recovery.
What does rehabilitation involve?
Recovery from a NOF fracture is measured in months, not weeks. The timeline varies depending on your age, pre-fracture fitness and activity level, the type of surgery performed, and how your bone heals — but a realistic general framework looks like this.
In hospital and in the first weeks at home, the focus is on safe mobility — getting in and out of bed, chair transfers, and walking with a frame or crutches while respecting weight-bearing restrictions set by your surgeon. Falls prevention is a priority from the outset, and your physiotherapist will assess your home environment and advise on modifications or aids that reduce risk.
From one to three months, progressive strengthening of the hip, gluteal and quadriceps muscles begins in earnest. Balance and proprioception training is introduced as weight-bearing improves. Walking distance and confidence increase steadily. Most people are walking independently with a walking stick by eight to twelve weeks, though this varies considerably.
From three to six months, the focus shifts to restoring full function — returning to stairs, outdoor walking, driving (subject to clearance from your surgeon), and where relevant, returning to activities like gardening, golf or bowls. Exercise physiology plays an important role in this phase for patients who want to rebuild their overall fitness and strength beyond basic functional mobility.
For patients with underlying osteoporosis, addressing bone health is an essential component of long-term management and falls prevention. Our Exercise Physiologist Ash O'Regan has specific experience in osteoporosis management and our Balance and Bones exercise classes are designed specifically for this population.
Will I walk normally again?
This is the question most patients and their families want answered. For the majority of older adults who were independently mobile before their fracture, the goal of physiotherapy is to return them to that level of function. Many achieve it. The honest answer is that outcome depends significantly on pre-fracture fitness, the degree of bone health, the presence of other medical conditions, and how consistently rehabilitation is pursued. What is well-established is that physiotherapy-guided rehabilitation gives you the best possible chance of the best possible outcome.
If you are recently discharged from hospital following a NOF fracture, or are supporting a family member through recovery, please get in touch. Our team treats patients across Brisbane's southside including Tarragindi, Coorparoo, Holland Park, Greenslopes and Mt Gravatt, and we can arrange home visits or telehealth appointments for patients who cannot initially travel to the clinic. Call us on 07 3706 3407 or book online below.
Book your initial physiotherapy appointment
