Hip Fracture Treatment

There are many different treatments for hip fractures that largely depend upon the type of fracture.

Treatment terms you may hear of include: pin and plate, intra medullary nailing and various types of hip replacement.A hip fracture is a break in the upper quarter of the femur (thigh) bone. The extent of the break depends on the forces that are involved. The type of surgery used to treat a hip fracture is primarily based on the bones and soft tissues affected or on the level of the fracture.

Anatomy

The “hip” is a ball-and-socket joint. It allows the upper leg to bend and rotate at the pelvis.

An injury to the socket, or acetabulum, itself is not considered a “hip fracture.” Management of fractures to the socket is a completely different consideration.

Causes & Symptoms

Causes

Hip fractures most commonly occur from a fall or from a direct blow to the side of the hip. Some medical conditions such as osteoporosis, cancer, or stress injuries can weaken the bone and make the hip more susceptible to breaking. In severe cases, it is possible for the hip to break with the patient merely standing on the leg and twisting.

Symptoms

The patient with a hip fracture will have pain over the outer upper thigh or in the groin. There will be significant discomfort with any attempt to flex or rotate the hip.

If the bone has been weakened by disease (such as a stress injury or cancer), the patient may notice aching in the groin or thigh area for a period of time before the break. If the bone is completely broken, the leg may appear to be shorter than the noninjured leg. The patient will often hold the injured leg in a still position with the foot and knee turned outward (external rotation).

Complications

The complication rate after arthroscopic surgery is very low. If complications occur, they are usually minor and are treated easily.

Possible postoperative problems with knee arthroscopy include:

  • Infection
  • Blood clots
  • Knee stiffness
  • Accumulation of blood in the knee

Recovery

After surgery, you will be moved to the recovery room and should be able to go home within 1 or 2 hours. Be sure to have someone with you to drive you home and check on you that first evening. While recovery from knee arthroscopy is faster than recovery from traditional open knee surgery, it is important to follow your instructions carefully after you return home.

  • Pain Management

    After surgery, you will feel some pain. This is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster. Medications are often prescribed for short-term pain relief after surgery. Many types of medicines are available to help manage pain, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anaesthetics. A combination of these medications may improve pain relief, as well as minimise the need for opioids.

    Be aware that although opioids help relieve pain after surgery, they are a narcotic and can be addictive. It is important to use opioids only as directed by your doctor. As soon as your pain begins to improve, stop taking opioids. Talk to the orthopaedic team if your pain has not begun to improve within a few days of your surgery.

  • Medications

    In addition to medicines for pain relief, you may also be recommended medication such as aspirin, clexane or Xarelto to lessen the risk of blood clots.

  • Swelling

    Keep your leg elevated as much as possible for the first few days after surgery. Apply ice as recommended by your doctor to relieve swelling and pain.

  • Dressing Care

    You will leave the hospital with a dressing covering your knee. Keep your incisions clean and dry. Instructions will be given which will tell you when you can shower or bathe, and when you should change the dressing (usually 1 week). The orthopaedic team will see you in the office a few days after surgery to check your progress, review the surgical findings, and begin your postoperative treatment program.

  • Bearing Weight

    Many patients need crutches or other assistance after arthroscopic surgery. In most cases you will be able to weight bear. If thing differ, Dr Hutabarat will tell you when it is safe to put weight on your foot and leg. If you have any questions about bearing weight, please call the hospital or the rooms.

  • Rehabilitation Exercise

    You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee. Therapeutic exercise will play an important role in how well you recover. A formal physical therapy program may improve your final result.

  • Driving

    Dr Hutabarat will discuss with you when you may drive. Typically, patients are able to drive from <1 to 3 weeks after the procedure.

Frequently Asked Questions (Knee Arthroscopy)

  • How long am I in for?

    Just the for part of the day. There is a bit of time waiting around before and after the surgery so allow about 4 hours

  • How much does it cost?

    Surgeons charge different fees for many different reasons so it pays to ask around and get other opinions! We do a quote for all our patients. Don’t be afraid to ask questions. We like questions and are happy to answer them.

  • When can I return to sport?

    This depends upon the sport, the level of its intensity and the damage in your knee. We want to get you back as soon as we can and will tailor your return to your situation.

  • When can I get it wet? Or swim? Or surf?

    Generally wounds need to stay dry for two weeks and then we may give a bit more time as a precaution. Dr Hutabarat has his personal method of an early return to the ocean if it’s pumping. This can be discussed on a case by case basis.

  • What about timing for my holidays/travel?

    This is a very important question! Its best to allow 3 weeks before a trip… again it depends on the situation.

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