Hip fractures are often treated with surgery with the same goals in mind – restore mobility and function. Eliminating convalescent time is crucial to preventing blood clots, bed sores, pneumonia and all the problems associated with prolonged bed rest. The ability to achieve early mobility after such a fracture requires a solid construct to be surgically created, and this construct depends largely upon the exact location of the fracture.
The hip is a ball and socket joint, with the ball resting atop the thigh bone or femur. The two most common types of hip fractures are neck fractures (just below the ball of the hip) and intertrochanteric fractures (just above the shaft of the thigh bone but below the neck). When the former occurs, the blood supply is disrupted and usually a replacement is necessary because the bone in the ball is at high risk for dying and not healing. When the latter occurs, the break is lower, and healing is very predictable. This allows the ball and socket joint to be salvaged by fixing the bone with either a plate or rod and screws and allowing the bone to heal itself. Both replacing the hip and fixing the hip allow early mobility and can significantly diminish the pain from the fracture.
Keep in mind that there is a spectrum of injuries and many factors are taken into consideration when planning any surgery. Only your surgeon can fully counsel you on his or her recommendations. With early operative intervention after hip fractures, morbidity has been dramatically improved and restoration of function is always our goal.
Although this technology has been refined over several decades, and outcomes are better than ever, there are unique risks inherent to the operation. With careful planning these risks are minimized but it is important to have this discussion with your surgeon prior to the operation to be appropriately informed. By understanding these risks and expectations of benefits, our patients are able to achieve the best outcomes possible.