You can’t let the situation take its course and leave a hip fracture without proper treatment: for older people, this attitude to the problem can be fatal. Treatment is mandatory - whether it be conservative methods or surgery.
Surgical treatment is considered the most effective and radical, but the need for it is not always present. For example, with an impacted fracture, or if the lower segment of the neck is damaged, the help of a surgeon may not be needed. In addition, surgery for an elderly person may simply be contraindicated - for example, due to old age, with severe disorders of the internal organs. 
Conservative treatment usually consists of the following mandatory steps:
- Examination of the patient with further placement in a specialized orthopedic or trauma department.
- Implementation of skeletal traction during the first 8 weeks after the fracture.
- Manual therapy, massage procedures.
- Mandatory use of crutches after removal of skeletal traction.
- Attempts to involve the affected limb for walking and movement under strict medical supervision, not earlier than 4 months after the injury.
If we are not talking about an operation, then the first thing the doctor will offer is to ensure immobilization and skeletal traction of the affected leg. How does this procedure take place?
- The damaged articular area is cut off with local anesthetics (for example, based on novocaine).
- Set the traction for a period of up to ten days.
- After the specified time, the pull-out structure is removed.
- Turn the patient on one or the other side, raise the head, provide a semi-sitting and sitting position.
- Approximately three weeks later, under the supervision of a doctor, an attempt is made to move the patient on crutches.
Further, in a satisfactory condition, the patient is prepared for discharge. However, he should move only on crutches, accompanied by an assistant. Only the attending physician should decide on the abolition of crutches.
Surgery is an important decision for both the doctor and the patient. The doctor must be sure that the elderly person will normally tolerate anesthesia and the intervention itself.
In many cases of hip fractures, the help of a surgeon is mandatory. The nature of the operation itself depends on the type of bone damage, on its scale. Most often, the fracture site is reinforced with a special design, which includes spoke-shaped or rod-shaped fasteners and / or screws. In severe cases, joint replacement may be required.
If the question is raised about the operation, then it is recommended to carry it out as soon as possible. The only factor in which the intervention can be postponed is the presence of temporary contraindications.
The general principles of surgical treatment are as follows:
- such treatment is always performed under anesthesia;
- in the presence of bone fragments, their reposition is preliminarily carried out;
- in case of simple fractures of the femoral neck, the intervention can be carried out without resorting to articular opening, using X-ray control;
- in complex fractures, the joint capsule is opened.
Endoprosthetics is used mainly in elderly patients, whose injury was accompanied by displacement of fragments, as well as in case of necrosis of the head of the bone.
Care for a hip fracture in the elderly
Proper care and good attitude of close people are important conditions for the speedy recovery of an elderly person who has received a hip fracture. In addition to stabilizing the state of the psyche, in order to accelerate the restoration of bone tissue, it is also necessary to perform special therapeutic exercises. It is important to prevent and eradicate the development of depression, depression: if necessary, you can additionally connect a psychotherapist to the treatment.
Close people should provide the victim with a healthy sleep, a complete diet. It is also recommended to conduct a course of massage procedures, to treat existing chronic pathologies. All activities in the complex will help to quickly deal with the problem.
You can not leave a sick person alone: he should always feel the support and participation of his relatives. To prevent the development of depression, doctors recommend spending time together, making plans for the future. It is good if the patient is able to perform feasible housework, as well as independently serve himself (for example, on crutches or sitting on a bed). And performing simple physical exercises to music will allow the patient to be distracted and improve his mood.
The duration of the rehabilitation period for a hip fracture in the elderly is difficult to accurately determine. This period depends on many factors, such as the complexity, type of fracture, age and general health of the victim. However, doctors believe that the duration of rehabilitation cannot be less than six months. 
In general, the recovery period can be figuratively divided into the following stages:
- Starting from the third day after the plaster is applied, the patient is recommended to start massage procedures: first, the lumbar area is massaged, gradually moving to a healthy leg. Only after 7-10 days they begin to massage the damaged limb, not forgetting about caution and accuracy.
- After removing the cast, it is allowed to gradually move the knee joint, making light movements under the supervision of a medical specialist. After 4 weeks, such exercises can be done independently, bending and unbending the leg at the knee. Extra movements that are not provided for by the medical instructions should not be performed.
- After about three months, the doctor may allow the patient to get out of bed using crutches. At the same time, leaning on the injured leg is still not allowed.
- The load is gradually increased, and after six months the patient is allowed to try movement without crutches.