Home > Hip Fracture Repair (Hip Pinning)
Surgery is usually the best treatment for a broken (fractured) hip. Two types of surgery are used.
Hip pinning surgery to repair a hip fracture involves two main steps:
During surgery to fix a fractured hip, your doctor will make one or two cuts (incisions) over the broken bone in your hip.
The pieces of bone are moved back into the right position, then held in place using metal pins, screws, nails, rods, or plates.
You may have X-rays to see if the pins and plates are in the correct place.
The doctor uses stitches or staples to close the incisions.
The surgery takes 2 to 4 hours.
Doctors usually use general anesthesia for hip fracture surgeries, which means you'll be asleep during surgery. But sometimes they use regional anesthesia, which means you can't feel the area of the surgery and you are sleepy but awake. The choice depends on your doctor, on your overall health, and, to some degree, on what you prefer.
Right after surgery
hip fracture, you will have medicine to control pain
and perhaps medicine to prevent blood clots (anticoagulants). You may have a
urinary catheter so you don't have to get out of bed
to urinate. You may also have a compression pump or compression stocking on
your leg, which squeezes your leg to keep the blood circulating and to help
prevent blood clots. And you may have cushion placed between your legs to keep your hip in the
correct position. It is not unusual to have an upset stomach or feel
constipated, so talk with your doctor or nurse if you don't feel well.
Your doctor may teach you to do simple breathing exercises to help
prevent congestion in your lungs while your activity level is low. You may also
learn to move your feet up and down to flex your muscles and keep your blood
circulating. And you may begin to learn how to keep your hip in the right
position while you move in bed and get out of bed.
It is very
important to start moving around soon after surgery. This will speed recovery
and reduce complications. On the first day after surgery, you will most likely
be moved out of bed into a chair for a short time. And on the second day after surgery, you will probably begin
Over the next few days, your physical therapist will help you get in and out of bed and chairs, walk, and perhaps go up and down stairs. He or she will help improve the movement (range of motion) and strength in your hip.
probably stay in the hospital for about 2 to 4 days after surgery. You may be
moved to an extended-care facility for rehabilitation (rehab) before going home. There, you can get help with daily activities, such as bathing on a bath stool.
You will probably need a walking aid—a walker, cane, or crutches—for several
months. And full recovery may take up to a year. For more information on using
walking aids, see:
There are many issues to consider after hip surgery.
Older adults often need extensive care, including
physical therapy and help with cooking, taking
medicine, and personal care. Anticoagulant medicines are prescribed to reduce
the risk of blood clots and associated
pulmonary embolism, or
thrombophlebitis. You will probably keep taking this
medicine until you are walking frequently and well. This often takes at least 3
After hip fracture surgery, your doctor will encourage you
to participate in a rehab program. Research shows that 6
months of outpatient rehab that includes strength training can improve quality
of life and reduce disability.1 Following a rehab
program is very important, because it will speed up your recovery and allow you
to return to daily activities sooner.
Surgery is done to keep the broken pieces of the hip in place so they can heal faster. Some kinds of broken bones heal on their own in a cast. But a broken hip is not likely to heal well without surgery.
Surgery usually works well, but you will need to be patient.
Getting better will probably take a long time. And you may never be able to get
around as well as you could before.
Surgery is usually the best choice after a hip fracture, because it stabilizes the bone so you can move around sooner.2 This helps prevent other problems such as pressure sores and weakness. Surgery also makes it more likely that the bone will stay in place so the fractured leg is not a little shorter than the other leg after it is healed.2
The risks of hip replacement surgery can be divided into two groups:
Reduction (getting the bone lined up correctly) and
internal fixation (stabilizing broken bones) often are done on younger, active
people. Hip replacement surgery often is done on older, less active adults. In
deciding which of these methods to use for repairing a hip fracture, your
surgeon will consider the type of fracture, your age and activity level, and
also the possible trade-offs. Research on displaced hip fractures (where the
bones are not aligned) shows that, in the long term, total hip replacements may
need to be redone less often than internal fixation, but there is also more
time in surgery, a greater chance of infection, and possibly a greater chance
of death from hip-replacement complications.3
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Binder EF, et al. (2004). Effects of extended
outpatient rehabilitation after hip fracture: A randomized controlled trial.
JAMA, 492(7): 837–846.
Oliver D, et al. (2010). Hip fracture, search date
April 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
Bhandari M, et al. (2003). Internal fixation compared
with arthroplasty for displaced fractures of the femoral neck. Journal of Bone and Joint Surgery,
May 10, 2011
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Kenneth J. Koval, MD, MD - Orthopedic Surgery, Orthopedic Trauma
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