What is hip fracture surgery?
Hip fracture surgical treatments
Hip fracture treatment depends on a number of variables. The two main considerations are the exact location of the fracture and whether the fracture is stable or unstable. Defined below are three types of hip fractures. Each is paired with their common surgical treatment:
Intertrochanteric hip fracture
An intertrochanteric hip fracture occurs between the base of the femoral neck and the top of the femoral shaft.1
Depending on a variety of factors including the stability of the fracture, the surgeon will typically decide to use either of the following:
- A compression hip screw, which is a single large screw that slides within a plate.1
- An intramedullary nail, which inserts 1 or 2 screws in the head of the femur. These pass through a nail that is placed in the shaft of the femur.1
Intracapsular hip fracture
An intracapsular hip fracture is a fracture in the neck of the femur. The surgeon will typically decide to fix the fracture with individual screws or a compression hip screw. Depending on the patient, the surgeon may opt for a partial or total hip replacement.1
Subtrochanteric hip fracture
A subtrochanteric hip fracture occurs within the shaft of the femur and is most commonly treated with an intramedullary nail.1
Recovery options will be discussed with your treating physician before and after surgery. Typically, patients are released from the hospital to an inpatient rehabilitation facility to undergo intensive physical therapy. Others are able to go home, where they pursue rehabilitation on an outpatient basis. Your surgeon and care team will explain your options and help design a recovery plan for you to follow.
Your physical therapists may begin treatment as early as two to four hours after surgery. This is important - it's the beginning of your journey towards regaining strength and better range of motion.
The rehabilitation team will work together to provide the care and encouragement you need during the first few days after surgery. They will teach you some simple exercises to be done in bed that will strengthen the muscles in the hip and lower leg.
Your physical therapist will also teach you how to perform simple tasks. Although these are simple activities, it's very important that you learn to do them safely:
- Moving up and down in bed
- Going from lying to sitting
- Going from sitting to standing
- Going from standing to sitting
- Going from sitting to lying
Another important milestone in early physical therapy is for you to learn to walk safely - using a walker, crutches, or another assistive device. Your therapist will teach you the proper techniques for walking on level surfaces and stairs.3
Being home after surgery can be difficult. Cooking and other simple daily activities, such as bathing, will likely be more difficult to do alone. Assistive equipment such as dressing aids, raised toilet seats, bath benches, and handrails may be helpful. Your local chapter of the Arthritis Foundation or a medical supply company may be able to help you find assistive devices. Your physical therapist can also help with choosing and locating them.4
Frequently asked questions
Here are answers to some common questions asked by hip fracture patients:
Can I be as active as I was before?
After a hip fracture, you may not be able to move around as easily as you did before.
When will the pain in my hip stop?
Your hip will likely be sore for several weeks after surgery. This pain can be managed with medication from your surgeon. The pain should also reduce over time while you regain your strength by following your rehabilitation exercises.
Why do I need to begin doing exercises right after surgery?
Exercise is needed for proper healing. Many of the exercises are geared towards helping a patient prevent blood clots after surgery. Other exercises are used to build strength to help you get out of bed and get moving.
When can I go home?
This often depends on your health and how well you can get around. You'll usually leave the hospital within a week. However, you may need to go to a rehab center or skilled nursing facility before returning home.
How long before I can use the bathroom on my own?
Your catheter is removed once you can physically make it to the bathroom. This is often a day or two after surgery. A therapist will teach you how to get on and off the toilet safely.5
Following up with your doctor
It is important to make a follow up appointment as directed by your surgeon. Be sure to contact your doctor if you experience any of the following symptoms:
- Increased hip pain
- Pain or swelling of your calf or leg
- Fever above 100.4°F or shaking chills
- Excessive swelling, increased redness, or any drainage from the incision6
Call 911 if you experience any chest pain or shortness of breath!
Consider the TRIGEN◊ INTERTAN◊ Intertrochanteric Nail
The TRIGEN INTERTAN Intertrochanteric Antegrade Nail is proven to offer the following post surgery benefits
time to fracture union7
high return to pre-fracture status7
risk of implant failure and non-union7
Important safety notes
Not all patients are candidates for the TRIGEN INTERTAN Hip Fracture Procedure. Discuss your condition and treatment options with your surgeon. Individual results of hip fracture repair can vary. There are potential risks to hip fracture surgery such as implant failure, limb length discrepancy, loss of anatomic position (nonunion, malunion with rotation or angulation), infections (both deep and superficial), irritational injury of soft tissue (including impingement syndrome), and metal sensitivity reactions and/or allergic reactions to foreign materials. Do not perform high impact activities such as running and jumping unless your surgeons tells you these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level, fail to control body weight or suffer from accidents such as falls. The information on this website is for informational and educational purposes only and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.
- Ruecker AH, Rupprecht M, Gruber M, Gebauer M, Barvencik F, Briem D, Rueger JM. The treatment of intertrochanteric fractures: results using intramedullary nail with integrated cephalic cervical screws and linear compression. Journal of Orthopaedic Trauma. 2009 Jan;23(1):22-30.
- Cabrera JA, Cabrera AL. Total hip replacement. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 61.
- Harkess JW, Crockarell JR. Arthroplasty of the hip. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 3.
- Nherera, L., Dunbar, C., Ridgway, J., Horner, A.The TRIGEN INTERTAN Intertrochanteric Antegrade Nail: A Systematic Literature Review and Meta-analysis of Clinical Outcomes Compared to Standard of Care in the Treatment of Intertrochanteric Hip Fractures. 2017;4(1).