Hip fracture surgery

Hip fracture surgery is a procedure to repair a break in the upper part of the thigh bone (femur) near the hip joint, or to repair a break in the hip socket. Surgery is not necessary for all hip fractures. But when the fracture is significant or displaced—meaning the broken pieces of bone have shifted out of their normal position—it may need surgical repair to heal properly. The main goals of broken hip surgery are to stabilize the fracture, relieve pain, and get you moving again as soon as possible. This helps restore normal function and prevent problems that may develop from staying immobile too long.

Penn Medicine is known worldwide for its advanced treatment of orthopaedic injuries. We offer the most comprehensive trauma and fracture care in the southeastern Pennsylvania and New Jersey regions. From pain management and physical therapy to advanced surgical interventions, our hip pain specialists offer solutions to relieve hip pain and restore mobility.

Once our imaging team has taken scans of your hip, we’ll devise a hip fracture treatment approach based on the type of fracture, your age, overall health, and bone strength. Hip fracture surgery is often done quickly, within 24 to 48 hours of the injury if possible, so the immediate focus is on getting you stable and ready for surgery.

• Limited mobility: You may be advised to stay in bed to avoid putting weight on your injured hip.
• Pain management: Medications are given to help control pain from the fracture.
• Fasting: You shouldn’t eat or drink after midnight before surgery.
• Medication adjustments: Blood thinners like aspirin may need to be stopped before surgery, along with some other medications like anti-inflammatory drugs and certain diabetes medications.
• Medical tests: You may have x-rays, blood tests, and an electrocardiogram (EKG) before surgery.
• Physical therapy: You may be assessed by a physical therapist and given exercises to strengthen hip muscles.
• Skin preparation: The surgical area will be cleaned and may be shaved.
• Intravenous (IV) line: A needle will be placed in a vein to give fluids and medications.
• Urinary catheter: A tube may be inserted to monitor urine output.
• Anesthesia consultation: The anesthesiologist will discuss anesthesia options and risks with you.

Recovery time, rehabilitation process, and outcomes vary based on factors like age, overall health, and type of hip fracture surgery. Your care team will devise a specific recovery plan and discuss the details with you. The process may include:

• Physical therapy: You are encouraged to move as quickly as possible. Physical therapy usually starts within 24 hours.
• Pain management: You’ll receive medications to deal with your pain effectively while minimizing opioid use.
• Hospital stays: Most people remain in the hospital for two to four days after surgery.
• Rehabilitation: Depending on your condition upon leaving the hospital, you may continue recovery at an inpatient rehabilitation facility or receive outpatient therapy.
• Ongoing exercises: You are likely to be given at-home exercises to improve strength, mobility, and balance.
• Follow-up care: You’ll have periodic check-ups with the surgeon to monitor healing.
• Gradual return to activities:
  • Driving may be possible around six weeks after surgery.
  • Other recreational activities may resume in about three months.
  • Full recovery may take three to six months or sometimes up to a year.

Hip fracture surgery can involve risks, especially for older patients who may have other health issues like heart problems, weakened immune systems, or fragile bones. Additionally, older patients may have a harder time recovering from surgery, leading to longer hospital stays and a higher chance of complications.

Risks include:

• Infection
• Blood clots
• Pneumonia
• Heart attack or stroke
• Confusion or breathing problems from anesthesia
• Delayed healing
• Bedsores
• Hip dislocation
• Bleeding

While the risks of surgery are significant, especially in older or frail patients, the potential benefits of repairing the hip to restore function and mobility usually outweigh these risks. Your Penn Medicine care team will consider your overall health, type of fracture, and potential for recovery, and they’ll discuss your specific risks and benefits with you.

Penn Medicine brings precision care and healing support to people whose mobility and quality of life are at stake due to hip fracture. We provide deep expertise from a range of orthopaedic specialists who work together to bring you relief and get you moving again.

Our treatments are supported by research conducted in our specialized labs, where we study orthopaedic implants and train future experts. By combining the latest scientific discoveries with clinical practice, we excel in developing new approaches to trauma and fracture care. This commitment to research means you’ll receive the most advanced hip fracture treatments to help you regain stability, strength, and overall well-being as quickly and safely as possible.