Hip fracture surgery is a medical procedure used to treat fractures in the upper part of the thigh bone (femur) near the hip joint. It involves stabilising the broken bone or replacing parts of the joint to restore function and mobility. The approach varies depending on the type of fracture, the patient’s age, and their overall health, with the goal of enabling patients to regain independence and minimise complications.
When is Hip Fracture Surgery Needed?
Hip fracture surgery is typically advised for patients experiencing the following:
Severe Pain and Immobility
A hip fracture often results in significant pain and an inability to stand or walk, necessitating immediate medical attention.
Trauma or Falls
The procedure is commonly required for older adults who suffer fractures due to low-impact falls, often linked to conditions like osteoporosis.
Increased Risk of Medical Complications
Untreated hip fractures can lead to complications such as blood clots, infections, or muscle atrophy from prolonged immobility.
Pre-existing Joint or Bone Conditions
Individuals with arthritis or brittle bones are more prone to fractures that need surgical correction.
Benefits of Hip Fracture Surgery
Surgery for a hip fracture offers several advantages that support recovery and long-term wellbeing. These include:
Pain Management
By stabilising the fracture or replacing the damaged joint, the surgery alleviates the discomfort associated with broken bones.
Restoration of Mobility
Patients are better able to regain movement and resume daily activities after the surgical site heals.
Improved Long-Term Functionality
Surgical intervention ensures the hip heals correctly, preventing deformities or issues that could impair future movement.
Reduced Risk of Secondary Issues
By promptly treating the fracture, complications such as blood clots or infections can be minimised.
Surgical Techniques for Treating Hip Fractures
The surgical approach depends on the location and severity of the fracture, as well as the patient’s overall health and mobility levels.
Internal Fixation
This method uses screws, metal plates, or rods to stabilise the broken bone pieces, allowing them to heal in the correct alignment. It is typically used for intertrochanteric and subtrochanteric fractures and is effective in preserving the natural joint structure. Advances in surgical tools ensure effective fixation while minimising disruption to surrounding tissues.
Hemiarthroplasty (Partial Hip Replacement)
In cases of femoral neck fractures where the ball of the joint is damaged but the socket remains intact, the ball is replaced with a prosthetic implant. This approach often results in quicker recovery times compared to total hip replacement and is suitable for older adults with lower activity levels.
Total Hip Replacement
For severe fractures or cases involving additional joint damage (e.g., arthritis), both the ball and socket of the hip joint are replaced with artificial components. This procedure supports greater long-term mobility and durability, making it ideal for younger or more active patients.
Preparing for Surgery
Thorough preparation ensures a smoother surgical experience and optimises recovery outcomes.
Medical Assessment and Imaging
Your doctor will review your medical history and conduct imaging studies, such as X-rays or MRI scans, to confirm the fracture type and plan the surgery.
Discussion of Current Medications
You may need to temporarily stop certain medications, such as blood thinners, to reduce the risk of bleeding during surgery. Discuss all medications and supplements with your doctor.
Pre-operative Instructions
Specific guidance may include fasting for several hours before surgery and using antiseptic solutions to cleanse the surgical site. Following these instructions helps minimise the risk of anaesthetic side effects and surgical infections.
Step-By-Step Procedure
Anaesthesia Administration
Anaesthesia is provided to ensure a pain-free procedure. General anaesthesia puts the patient to sleep, while spinal anaesthesia numbs the lower body and allows the patient to remain conscious.
Surgical Incision
An incision is made near the hip to expose the fractured bone. The size and location of the incision depend on the chosen surgical technique.
Bone Stabilisation or Joint Replacement
For internal fixation, metal hardware like screws or plates are placed to hold the bone in position. For partial or total hip replacement, the damaged portions of the bone and joint are removed and replaced with prosthetic components.
Closure and Dressing
After the fracture is stabilised or the joint replaced, the incision is closed with sutures or staples. A sterile dressing is applied to protect the area during the initial healing phase.
Recovery and Aftercare
Post-surgical care is crucial for healing and regaining functionality:
Immediate Care
Patients typically remain in hospital for a few days, where pain is managed with medications, and measures like compression stockings or blood-thinning medications are used to prevent blood clots.
Physiotherapy
Rehabilitation begins early, often within 24–48 hours of surgery. A physiotherapist will design a customised exercise plan to strengthen muscles, improve flexibility, and promote mobility.
Walking Aids and Home Adjustments
Devices such as walkers or crutches help patients gradually resume weight-bearing activities. Home adjustments like raised toilet seats and grab bars can enhance recovery safety and convenience.
Follow-Up Care
Regular medical check-ups track progress, address any concerns, and ensure the surgical site is healing properly. Bone-strengthening strategies, including calcium and vitamin D intake, are often recommended.
Potential Risks of Hip Fracture Surgery
Although hip fracture surgery is generally effective, it carries some risks. Infections at the surgical site may occur but are rare with proper care. Blood clots in the legs or lungs are another potential complication, often managed with medications and early mobilisation. In some cases, the implanted prosthetic components may loosen or wear out over time, requiring further interventions. Rarely, nerves or blood vessels around the hip may sustain damage during the procedure.
Conclusion
Hip fracture surgery provides an effective way to restore mobility and support long-term recovery. Careful preparation, detailed planning, and adherence to post-surgical care are key to achieving the best outcomes. Each patient’s condition is different, and consulting with a healthcare professional ensures that the most suitable treatment plan is selected.
Schedule a consultation today to discuss your treatment options and begin your recovery journey.
