Hip fracture surgery is the process of correcting a break of the upper part of the femur near the hip joint. This injury is frequent especially among elderly people with osteoporosis, and it is dangerous if not well managed. Here is an overview of the key aspects of hip fracture repair:Here is an overview of the key aspects of hip fracture repair:
Types of Hip Fractures
Intracapsular Fractures: They affect the capsule of the hip joint and can include femoral neck fractures.
Extracapsular Fractures: Happen outside the capsule such as intertrochanteric and subtrochanteric fractures.
Treatment Options
The kind of surgery that is to be done depends on the location of the fracture, the degree of the fracture, the age of the patient, his general health and his level of activity.
Internal Fixation:
Screws and Plates: To fix the broken bone fragments, metal screws and plates are used to keep them in place as they knit.
Intramedullary Nails: A metal rod is placed in the marrow canal of the femur to help with the fracture.
Hip Replacement:
Partial Hip Replacement (Hemiarthroplasty): The femoral head is the only part of the joint that is replaced.
Total Hip Replacement (Arthroplasty): Both the head of the femur and the acetabulum (hip socket) are replaced.
Surgical Procedure
Preparation: This section covers patient’s evaluation, anesthesia, and patient positioning.
Incision and Exposure: An incision is made to get to the site of the fracture.
Reduction and Fixation: The bone fragments are then arranged (reduced) and secured in position by screws, plates or rods.
Closure: The incision is then stitched or stapled and a dressing is placed over the area.
Postoperative Care
Pain Management: Pain relief through the use of drugs.
Mobilization: Initial mobilization and physiotherapy to help avoid conditions like deep vein thrombosis, muscle wasting, and joint contracture.
Rehabilitation: Further physical therapy to regain the ability to move and use the affected limbs.
Monitoring: Subsequent follow-up visits to assess the recovery outcomes based on clinical examination and imaging tests.
Complications
Some of the risks include sepsis, thromboembolism, implant failure, and anaesthetic complications. In elderly patients, there is also a risk of postoperative delirium and poor mobility.
Prognosis
The outcome depends on several factors such as the patient’s age, general health, the type of fracture and the effectiveness of the surgery and physiotherapy. It is crucial to seek medical intervention as early as possible to enhance the recovery process and minimize the chances of developing complications that may lead to disability.
Preventive Measures
For those at high risk of hip fractures, especially older adults with osteoporosis, preventive measures include:For those at high risk of hip fractures, especially older adults with osteoporosis, preventive measures include:
Fall Prevention: Enhancing safety at home, balance training, and strength training.
Bone Health: Calcium and vitamin D supplements, bone-strengthening medications, and alterations in diet and physical activity including weight-bearing exercises.
Hip fracture repair is a major surgery that demands the involvement of surgeons, anesthesiologists, nurses, and rehabilitation experts to ensure the patient gets the best care.