HIP NAILING FOR HIP FRACTURE

General Information

DEFINITION--A surgical procedure to reattach the broken fragments of the fractured femur (the large bone in the thigh that joins the hip bone to the hip joint).

BODY PARTS INVOLVED--The head and neck of the femur and the acetabulum (the socket of the hip bone that receives the femur to form the hip joint).

† To prevent prolonged bed confinement--usually dangerous in the elderly age group when hip fractures become more common.

SURGICAL RISK INCREASES WITH

• Obesity.
• Smoking.
• Excess alcohol consumption.
• Chronic illness, such as diabetes.
• Use of many drugs (be sure to inform the surgeon and anesthesiologist of all the medicines you take).

What To Expect

WHO OPERATES--Orhtopedic surgeon; general surgeon (sometimes).

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS--Before surgery: Blood and urine studies; x-rays of hip and lung.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• After anesthesia, the area adjacent to the fractured hip is cleaned, shaven and draped.
• An incision is made at a point allowing access to the fractured parts.
• The broken fragments are realigned under direct vision.
• Plates are fitted to hold the nail to be inserted into the fractured fragments.
• The nail is hammered into the broken parts to hold them together and give strength to the injured area of the bone.
• The plate is attached to healthy bone to hold the nail in place.

POSSIBLE COMPLICATIONS

• Surgical-wound infection.
• Excessive bleeding.
• Blood clots breaking loose and traveling to the lungs (pulmonary embolism).

AVERAGE HOSPITAL STAY--7 to 9 days, depending on the condition of the patient prior to hip fracture.

PROBABLE OUTCOME--Usually curable with surgery and rehabilitation.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--

vein blood clots.

• Avoid lifting heavy objects.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• A physical therapy program will be prescribed by your doctor. Usually start using a walker, then crutches, followed by a cane if necessary.
• Avoid vigorous exercise for 12 weeks after surgery or until your doctor determines healing is complete.
• Your doctor will advise you when it is safe to resume driving and sexual activity.

DIET

• As prescribed by your doctor.
• Vitamin and mineral supplements (sometimes).

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• New unexplained symptoms develop.
• Chills, fever, muscle aches or headaches develop. These may be signs of infection.
• You experience nausea or vomiting.