Hip Fracture - Treatment Overview
The goal of treatment for
hip fractures is to allow you to do, without pain,
most of the things you did before your fracture. The most common and almost
always the best treatment for a hip fracture is surgery. Surgery helps make
sure that the bones are lined up to heal correctly.
After your hip
fracture is diagnosed, you may have a pillow placed under the knee of your
injured leg. Or you may be placed in gentle skin traction to help keep you more
comfortable until surgery. Skin traction attaches a
light weight to your leg using tape, straps, or a special boot. And this weight
provides a constant pull on your leg.
Surgery is done as soon as
possible after a diagnosis of hip fracture, often within 24 hours. Having
surgery right away can help shorten your stay in the hospital and may decrease
pain and complications.1 But in some cases, surgery
may be delayed for 1 to 2 days for treatment of other medical problems, such as
heart or lung conditions, so that surgery will be less risky.
different types of surgery for hip fractures, depending on the location of the
break, the position of the bone fragments, and your age. Surgery for a hip
fracture may include one of the following:
- Internal fixation.
Internal fixation involves stabilizing broken bones with surgical screws, rods,
or plates. This type of surgery is usually for people who have fractures in
which the bones can be properly aligned. See Hip Fracture Repair (Hip Pinning) for more information.
- Hip replacement surgery (arthroplasty). Arthroplasty involves replacing part
or all of the joint with artificial (usually metal) parts. A partial hip
replacement may be done to replace the broken upper part of the thighbone
(femur) with artificial parts. In some cases, a
total hip replacement can be done if the hip joint area was already damaged before
the fracture by arthritis or an injury and the joint was not working correctly.
Arthroplasty is often done for
femoral neck fractures when the blood supply to the top of the thighbone is
damaged and there is a chance that the bone might die (avascular necrosis). And arthroplasty is often done when the fractured bones
cannot be properly aligned. See Hip Replacement Surgery for more information.
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.2