Open Reduction And Internal Fixation Of A Hip Fracture In Children

What you should know

Open reduction and internal fixation (ORIF) of a hip fracture is surgery to fix a broken bone in your child's hip. Open reduction means that caregivers move the bone back into the right place with surgery. Internal fixation means that hardware (such as rods or pins) is used to hold the broken bone together.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Risks

  • After ORIF, your child may get an infection. The fracture or surgery may damage the nerves in his leg. After surgery, your child's hip may not heal correctly, or it may fracture again. His bones may not grow back together, and he may need more surgery. He may need surgery to replace his hip with artificial parts. Depending on what part of the hip was broken, your child's bones may not grow correctly. Your child may get a blood clot in his leg. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in his body. The blood clot may break loose and travel to your child's lungs. A blood clot in the lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • Blood flow to the head of the femur could be poor, and the bone could begin to die. This can cause pain, swelling, trouble moving the hip, and changes to the shape of the femur. Surgery may be needed to treat this condition. Hardware placed during ORIF may move into the joint area, causing problems with bone growth. After ORIF, the angle of your child's hip bones may change, or the growth plate of his femur may close early. These changes could cause one of your child's legs to be shorter than the other, and cause trouble walking.

  • Without surgery, his bone fracture may not heal. His bones may not grow back together correctly. Your child may have nerve damage in his leg or long-term pain. Your child's legs may not grow evenly, and he may have lifelong problems walking and moving his hip.

Getting Ready

Before your child's surgery:

  • When you take your child to see his caregiver, bring a list of his medicines or the medicine bottles. Tell caregivers if your child uses herbs, food supplements, or over-the-counter medicine. If your child is allergic to any medicine, tell his caregiver.

  • Your child may need blood tests, an x-ray, bone scan, CT, MRI, or ultrasound before his surgery. These tests may show what kind of fracture your child has so caregivers can better plan his care. Ask for more information about these or other tests your child may need. Write down the date, time, and location of each test.

  • Write down the date, time, and location of your child's surgery.

The night before your child's surgery:

  • Ask caregivers about directions for eating and drinking.

The day of your child's surgery:

  • Ask your child's caregiver before giving him any medicine on the day of surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery on your child. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • An anesthesiologist will talk to you and your child before the surgery. Your child may need medicine to keep him asleep or numb an area of his body during surgery. Tell caregivers if anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • An incision will be made so caregivers can see the broken bone. Blood that has collected around the fracture may be drained. This will decrease pressure and help blood flow to the bone and the area around it. The femur head may be reshaped to help better fit the bone into place. If a disease caused the fracture, bone samples may be taken and sent to the lab for tests. The broken bone will be moved back into place.

  • Hardware, such as metal screws, rods, or pins, will be put through your child's bone. The hardware is put in to hold the bone in the correct place. X-rays may be used during surgery to check the hardware placement. Your child's hip will be moved by caregivers after surgery to see that it is moving as it should.

After your child's surgery:

Your child will be taken to a room where he can rest until he is fully awake. Caregivers will monitor him closely. Do not let your child get out of bed until caregivers say it is okay. Your child may be placed in a hip spica cast. This cast goes around your child's stomach and extends down his hip and thigh. Instead of a hip spica cast, your child may have a cast only on his injured leg. Your child may have a bar between his legs that is attached to his cast. This holds his bones and joint in place so they can heal.

Contact a caregiver if

  • Your child has a fever.

  • Your child's pain is getting worse.

  • You have questions or concerns about your child's surgery.

© 2014 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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