Is it possible to walk with a fractured femoral neck before or after treatment. -

After you have had a femoral fracture and undergone treatment (surgery), you might wonder how soon you can start walking again.

Whether or not you have had surgery for a femoral fracture, I will give you information on resuming walking after this injury.

For this I rely on my experience as a radiographer and on the results of medical scientific publications (all references at the end of the article).

Happy reading?😀 and feel free to ask questions in the comments or share your own experience.🙏

Last updated: March, 2025. Written by Juliet Semakula, a diagnostic radiographer.

Quick answer: It is generally not advisable to walk with a fractured femoral neck (broken hip) before treatment, as it causes severe pain and can worsen the injury. Yes, I have seen patients start to walk again after a fractured femoral neck treatment, with many patients starting to walk with assistance as early as the first day after surgery. Rehabilitation usually involves a gradual progression from non-weight-bearing to full weight-bearing over several weeks, supported by physiotherapy

▶️A quick reminder about femoral neck fractures

A femoral neck fracture is a serious, often life-changing injury occurring in the region just below the ball of the hip joint.

These kinds of fractures in elderly patients following low-energy falls, particularly those with osteoporosis, but can also occur in younger individuals due to high-impact trauma like motor vehicle accidents.

The diagnosis is made using an X-ray, after a doctor has examined you. The X-ray is then often shown to an orthopaedic surgeon who will decide your treatment plan.

I have seen must patients go through treatments such as:

🟣Surgery such as a hemiarthroplasty or intermediate hip with screws and nails.

🟣A return home the same day with a follow-up appointment for a consultation and an X-ray 6 weeks later. And possibly a physiotherapy prescription.

🟣A hospitalisation of a few days in an orthopaedics department

🟣Or a stay in follow-up care and rehabilitation.

X-ray images showing a femoral neck fracture before treatment and after surgery (Bernstein,2022)

The femur can break in several places. But most often, it breaks at the neck, at the top, at the hip. So, we will focus on the neck of femur fracture.

Normally, at this stage, the healthcare professionals who have been treating you have explained whether you are allowed to walk and how.

▶️What do we mean by “walking” after a hip fracture?

Walking” after a hip fracture refers to a progressive rehabilitation process known as early mobilisation.

It is not just about unassisted steps; it begins with basic movements and slowly advances toward independent mobility.

Early mobilization following hip fracture repair is thought to be an imperative part of postoperative management.

Bed rest has been associated with:

🟣Undesirable cardiovascular.

🟣Pulmonary and urinary effects.

🟣Reduced muscle tone.

🟣Loss of bone mineral density.

🟣Negative psychological effects

So, early mobilization has been associated with a reduction in postoperative complications such as thromboembolism, pneumonia, wound breakdown, pressure ulcers, and delirium.

Source: Kenyon-Smith,2019

According to the patients I see in radiology who have had femoral neck fractures there are many factors that will determine one’s ability to regain mobility following a hip fracture.

Things like one’s age. Pre fracture mobility and participating in physiotherapy postoperatively are factors that will determine your ability to regain mobility.

You can walk.

♦️Limping

♦️On one foot.

♦️With a walker or crutches.

♦️With a splint

After a hip fracture, in many cases, research indicates that roughly 79% of patients can walk on the same day or the day after their operation (Gray 2024)

▶️The different types of walking permitted or not after a hip fracture

Walking is normally encouraged as soon as 24 hours after surgery. However, the type of walking permitted will depend strictly on your surgeon’s prescribed weight-bearing status and the type of surgery performed

⏩Permitted Weight-Bearing Levels

The kind of permitted bearing levels I normally see ortho doctors assign are based on how the fracture was fixed.

♦️ Full Weight-Bearing.

Here you are normally advised to put 100% of your body weight on the leg. This is common after a hemiarthroplasty (partial hip replacement) unless otherwise instructed.

♦️️ Weight-Bearing as Tolerated.

Here you might be advised to put on as much weight as your pain level and balance allow.

♦️ Partial Weight-Bearing.

You may be instructed to put only a specific percentage (usually up to 50%) of your weight should go through the leg.

♦️ Minimal or Toe-Touch Weight-Bearing.

Here only about 10–25% of weight-like resting your foot as balance is allowed.

♦️ Non-Weight-Bearing.

Here zero weight is allowed, you may only “hop” or step using only the unoperated leg while supported by a walker or crutches

▶️What is Not Permitted after a hip fracture?

If you had a partial or total hip replacement, you may have hip precautions for up to 12 weeks to prevent dislocation

❌Do not bend your hip more than 90 degrees (e.g., avoid low chairs).

❌Do not twist your hip or swivel on the ball of your foot when turning, take small steps instead.

❌Do not cross your legs at the knees or ankles.

❌Avoid high-impact activities (running, jumping) and heavy lifting for at least 12 weeks.

▶️How do you know if you can walk or not, and how?

Whether you can walk after a femoral neck fracture will depend entirely on your surgeon’s assessment of the fracture’s stability and healing.

Normally after a femoral fracture treatment, you will have a multidisciplinary care team that will focus on your early mobility, pain management and rehabilitation to prevent any complications.

Review your surgical report (if you had surgery) and all the paperwork you received following your treatment.

Information about follow up and care will all be in these reports:

♦️Surgical dressings are typically checked at 10–14 days, when stitches or staples are removed.

♦️Immediate after the initial treatment you will begin walking with aids such as frame/crutches to prevent blood clots and chest infections.

♦️Patients come to us for a 6-week,2 months or 3 months check-up x-ray to check hardware and assess healing.

If you are still not sure, always call your doctor who diagnosed your fracture to ask for more information.

▶️ At what point can we be sure we can resume walking as before?

In general, the results of this X-ray are good: you are starting to heal well. In this case, you will be able to:

♦️Gradually let go of crutches (or a walker) if you still have them.

♦️Gradually start to apply a little more pressure over the course of days or weeks, if you were in full contact or partial support.

Timeline:

♦️Immediate (Day 1–3): Short, assisted walks in the hospital room or hallway using a walking frame or crutches.

♦️Early Recovery (Weeks 1–6): Gradual increase in indoor distance. You typically progress from a walker to crutches, then to a cane.

♦️️ Intermediate (Weeks 6–12): Many patients begin walking unaided indoors, but aids are still recommended for outdoors or uneven surfaces.

♦️Long-term (3+ Months): Return to “normal” walking and low-impact activities like gardening.

▶️Is it possible to have a fractured femoral neck and still be able to walk?

Yes, it is possible to walk with a fractured femoral neck. But if a fracture is suspected, it is critical to seek medical attention before you try to put weight on the affected leg.

I have seen patients with non-displaced, stable, or a stress fracture walking with the help of crutches.

While this often causes pain or a limp, some patients can still bear weight because strong muscles and ligaments temporarily hold the bone in place.

The risk factor in attempting to walk on a fractured hip can make it worse, leading to further injury, displacement, or complications.

So, this is not good enough. I have seen people who have managed to walk after breaking their neck of femur often ending up calling for help.

What to do!

If you have seen a doctor a fracture is ruled out, wait a few more days and reconsult if there is really no improvement.

We have come to the end of this article; any experience lets share in the comments section. Wishing you a quick recovery!