One of the most common fractures in orthopedics is a hip fracture. There are two main hip fractures which are classified by their anatomic location: a femoral neck fracture and an intertrochanteric fracture.
Most of the patients we see with hip fractures are over 70 years old, but occasionally it can occur in a younger patient after a motor vehicle accident or from a fall. Our goal is to try and repair these fractures within the first 24 hours for several reasons. Patients are at risk for blood clots and pneumonia when they are laying in bed. Until the fracture is fixed the patient is unable to get out of bed. Once the patient is cleared for surgery the method of fixation is to try and preserve the patient's own anatomy. We will use multiple partially threaded screws for fixing a femoral neck fracture. An intertrochanteric fracture is lower and it usually is displaced. The patient is placed on a fracture table in the operating room, the fracture is reduced with fluoroscopic aid and then is stabilized with an intramedullary rod. In some cases the femoral neck fractures patients do better with a hip prosthesis. This is a judgment call that we often make based on the patient's health and age.
Postoperatively, patients are encouraged to get out of bed and ambulate the next day. This is dependent on the patient's ambulatory status prior to the injury. A physical therapist will work with the patient to help them learn how to transfer out of bed as well as to ambulate with a walker. Most hip fractures heal without any problems in about 8 weeks. A patient will usually remain in the hospital for 3-5 days and then depending on their progress we try and have them transfer to a rehabilitation facility for continued physical therapy.