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Open Reduction And Internal Fixation Of A Hip Fracture

WHAT YOU SHOULD KNOW:

  • Open reduction and internal fixation (ORIF) is surgery to fix a fracture (broken bone) in your hip. A hip fracture happens when the top part of your femur (thigh bone) gets broken. The femur is the long bone in your thigh that attaches to your pelvis at the hip joint. The head of the femur fits into the acetabulum socket (hollow space) of the pelvis bone. This forms the hip joint and is held together by ligaments and muscles. Your femur usually breaks at the femur neck (narrow area below the head) or just below the neck. You can get a hip fracture when you fall or are in a vehicle or other impact accident. Medical conditions that weaken bones, such as osteoporosis or cancer, greatly increase your risk of having this injury.
    Hip


  • ORIF is surgery to put the broken parts your femur bone back together using special metal hardware. It also includes putting your hip joint back together. Your caregiver will make an incision (cut) on your hip to let him see the damaged bone. He will straighten your femur and put the broken pieces of bone close together. Caregivers may use special metal screws, bars, plates, and rods to hold the broken pieces of bone together. Caregivers may use an artificial implant (man-made part) to replace the head of your femur. This is fitted tightly inside your femur bone and secured in place. If your hip joint is weak or badly damaged, you may also need an implant to replace your hip socket. Having ORIF surgery can ease your pain and allow you to walk again.

INSTRUCTIONS:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.

  • Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for you to bleed or bruise. If you are taking a blood thinner:

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin and a soft toothbrush on your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports, such as football.

    • Be aware of what medicines you take. Many medicines cannot be used when taking medicine to thin your blood. Tell your dentist and other caregivers that you take blood-thinning medicine. Wear or carry medical alert information that says you are taking this medicine.

    • Take this medicine exactly as your caregiver tells you. Tell your caregiver right away if you forget to take the medicine, or if you take too much. You may need to have regular blood tests while on this medicine. Your caregiver uses these tests to decide how much medicine is right for you.

    • Talk to your caregiver about your diet. This medicine works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.

  • Pain medicines:

    • Acetaminophen: This medicine is used to decrease pain and lower a high body temperature (fever). Taking too much acetaminophen can hurt your liver. Read labels so that you know the active ingredients in each medicine that you take. Talk to your caregiver before taking more than one medicine that contains acetaminophen. Ask your caregiver before taking over-the-counter medicine if you are also taking pain medicine prescribed (ordered) for you.

    • NSAIDs: Nonsteroidal anti-inflammatory (NSAID) medicine may decrease swelling and pain or fever. This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

    • Pain medicine: You may need medicine to take away or decrease pain.

      • Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.

      • Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.

      • Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

  • Ask your caregiver when you need to return to have your wound checked and the stitches or staples removed. You may need to have blood tests.

Compression stockings:

Your caregiver may have you wear compression stockings after your surgery. These are tight elastic stockings that put pressure on your legs. The pressure is strongest in the toe and decreases as it goes towards the thighs. Wearing pressure stockings help push blood back towards the heart and helps prevent blood clots from forming. Ask your caregiver for more information on using compression stockings.

Diet:

You should be eating foods that are good sources of calcium and Vitamin D to help your bone heal. These include milk, yogurt, other dairy products, and tofu. You should also eat foods to help your hip wound heal. These include high protein foods such as chicken, beef, fish, and pork. You should also eat plenty of fruits and vegetables, such as citrus fruits and juice. If you are on an anticoagulant medicine, there may be some vegetables you should not eat. Ask your caregiver for more information about your diet after having hip surgery.

Preventing hip fractures:

  • Prevent falls: Falls are the most common way hip fractures happen. Doing the following can help reduce your risk of falling:

    • Avoid places and situations where you could fall, such as walking on icy sidewalks. Remove small rugs you could slip on at home and items you could trip over.

    • Get regular physical activity to keep your muscles strong. Ask your caregiver if you need an exercise program to increase your muscle strength.

    • Your caregiver may ask you questions to check your risk of slipping or falling. Some people, such as the elderly, have a greater risk of slipping and falling. Your caregiver may want to change some of the medicines you take that can put you at risk for falling. You may need to change more things in your home to decrease your risk of slipping or falling. Ask your caregiver for more information about what you should do to prevent falls and hip injury.

  • Prevent or treat osteoporosis: Having osteoporosis increases your risk of getting a hip fracture if you fall or are injured. Doing the following can help reduce your risk of having osteoporosis:

    • Activity: Do weight-bearing physical activities, such as walking and climbing stairs, on a regular basis. Doing this will help keep your bones strong.

    • Diet: Get enough calcium and vitamin D to keep your bones strong and decrease your risk of having fractures. Take vitamin supplements or eat foods rich in calcium and vitamin D, such as milk or cheese. Ask your caregiver for more diet information about calcium and osteoporosis.

    • Limit alcohol: Alcohol is found in adult beverages such as beer, wine, and hard liquor. Ask your caregiver for more information about alcohol use and osteoporosis.

    • Quit smoking: Stop smoking if you smoke cigarettes. Ask your caregiver for more information on how to stop smoking if you are having trouble quitting.

    • Treatment: Ask your caregiver for more information on health conditions and medicines that may weaken your bones. You may need other medicines or treatments to prevent or treat weakened bones.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • You feel very confused and have trouble thinking clearly or remembering things.

  • You have pain when passing urine or are passing little urine.

  • You have questions or concerns about your condition, medicines, or care.

SEEK CARE IMMEDIATELY IF:

  • You fall down and hurt yourself.

  • You are vomiting (throwing up) blood or having bowel movements (BMs) that are red or black colored.

  • You become weak on one side of your body, get a very bad headache, or have trouble talking or walking.

  • You have a seizure (convulsion), or lose consciousness.

  • Your bandages become soaked with blood.

  • Your stitches are swollen, red, or have pus coming out of them.

  • Your stitches come apart.

  • Your leg feels warm, tender, and painful. It may look swollen and red.

  • You have chest pain or trouble breathing that is getting worse over time.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.

Copyright © 2012. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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