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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 broken bone in your hip. A hip fracture is a break in the top of the femur or in the hip socket. The femur is the long bone in your thigh that attaches to your pelvis at the hip joint. The broken parts of your femur will be put back together with metal hardware. You may also need an implant to replace your hip socket.

AFTER YOU LEAVE:

Medicines:

You may need any of the following:

  • Acetaminophen decreases pain and fever. This medicine is available without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

  • Prescription pain medicine may be given. Do not wait until the pain is severe before you take your medicine.

  • Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

    • Tell your healthcare provider about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your healthcare provider tells you to. Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

    • You will need regular blood tests so your healthcare provider can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.

    • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

  • Take your medicine as directed. Call your 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.

Call 911 for any of the following:

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

  • You have chest pain when you take a deep breath or cough.

  • You suddenly feel lightheaded and short of breath.

  • You cough up blood.

Seek care immediately if:

  • You fall and hurt yourself.

  • You are vomiting blood or your bowel movements are red or black.

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

  • You have a seizure or lose consciousness.

  • Blood soaks through your bandage.

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

  • Your stitches come apart.

Contact your healthcare provider if:

  • You have a fever.

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

  • You have pain when you urinate or you cannot urinate.

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

Prevent deep vein thrombosis (DVT):

DVT is a condition that causes blood clots to form inside your blood vessels. This can happen after a major bone surgery. Ask your healthcare provider for more information about DVT. Your healthcare provider may have you wear pressure stockings to promote blood flow and prevent clots. He will give you a prescription for the right stockings for you. Do not buy over-the-counter pressure stockings unless your healthcare provider says it is okay. The stockings may not fit correctly or may have elastic that can cut off your circulation. You will be told how long to wear these stockings.


Follow up with your healthcare provider as directed:

You may need to return to have your wound checked and stitches removed. Your healthcare provider may also want to check you for osteoporosis. Osteoporosis is a condition that causes bones to become brittle and break easily after a fall. You will need treatment if you develop osteoporosis. Write down your questions so you remember to ask them during your visits.

Prevent falls:

Fall prevention is an important part of hip fracture recovery. The following may also help prevent another hip fracture:

  • Get regular exercise. Include exercises that strengthen your legs and improve your balance. Ask about the best exercise plan for you.

  • Talk to your healthcare provider about all of the medicines you take. Some medicines can cause dizziness or drowsiness and increase your risk for falls.

  • Have your vision checked regularly. Your vision may worsen over time and increase your risk for falls.

  • Use walking devices , such as canes or walkers, if you have trouble keeping your balance.

  • Make your home safe:

    • Improve the lighting in your home so that you can see well.

    • Add grab bars to the inside and outside of your tub or shower and next to the toilet.

    • Add railings to both sides of your stairways.

    • Remove throw rugs and other objects that can cause you to trip and fall.

Manage your hip fracture after surgery:

  • Ask about ways to control your pain. Ask about relaxation, nerve stimulation, or other pain relief methods if your pain medicine is not controlling your pain.

  • Increase the amounts of calcium and vitamin D you get as directed. Your healthcare provider may tell you to eat more dairy products, such as milk and cheese, for calcium. Spinach, salmon, and dried beans are also good sources of calcium. Cereal, bread, and orange juice may be fortified with vitamin D. You also get vitamin D from exposure to sunlight. Your healthcare provider may also suggest a calcium or vitamin D supplement. Do not take supplements unless directed. Eat high-protein foods to help your surgical wound heal, such as chicken, beef, fish, and pork. Also eat fruits and vegetables, such as citrus fruits and juice.

  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.

  • Occupational therapy: An occupational therapist teaches you skills to help with your daily activities.

Wound care:

Check the surgery site for signs of infection, such as redness, swelling, or pus. Change the bandage as often as directed and when it gets wet or dirty. Follow your healthcare provider's instructions on when you can bathe. Gently wash the part of your body that has the stitches. Do not rub on the stitches to dry your skin. Pat the area gently with a towel. When the area is dry, put on a clean, new bandage as directed.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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