Open Reduction And Internal Fixation Of A Hip Fracture In Children

GENERAL INFORMATION:

What is it?

• An open reduction and internal fixation (fix-a-shun) of a fractured (or broken) bone is called O-R-I-F for short. Surgery is used to fix your child's broken hip because the break is very bad or may have happened in several places. A hip fracture is a break in tip of the femur (long bone of the thigh) that joins with the pelvis. The pelvis and the end of the femur make the hip joint.
  
  
• This kind of fracture does not happen very often in children. But it is very serious, because it is so near the physis (fi-siss) or growth plate, and an important blood supply. Ask your caregiver questions so you will understand if your child's fracture may affect the growth of his bones. How long it will take your child's hip to heal is different for every child. It may take 6 weeks. But, children's bodies grow and change every day, so fractures usually heal faster than in adults. An x-ray will show when the broken bone is healed.

Causes: Since the tip of the femur is very strong in children, it usually takes a lot of force to break it. A broken hip often happens with trauma, such as a fall from a height or off a bike. Motorcycle or car accidents are also another cause of hip fractures. Fractures in children younger than 1 year of age are uncommon because their bones are very flexible and "rubbery." Fractures in these children may be caused by problems with how a bone was formed, tumors, or physical abuse.

Signs and Symptoms: Your child's hip may hurt, feel weak or numb, or tingle. It may be swollen or bruised and bleed if the skin is broken. His hip joint may not look normal. Your child may have a hard time moving his hip and leg. Or, your child may not be able to move it at all. He may limp or not be able to put any weight on his injured leg.

Care: Your child may need an x-ray, bone scan, CT, or MRI. Orthopedic (or-thuh-p-dik) hardware (screws or plates) will be used to hold the pieces of bone together while they heal. Your child may also need traction before a cast or splint is put on. Children are often put in a spica (special lower-body) cast or a splint. Your child may be in the hospital 3 to 6 days, but if he has special traction, it may be longer.

• Acetaminophen (uh-c-tuh-min-o-fin) or ibuprofen (i-bew-pro-fin) may help your child's pain. Caregivers may give your child stronger medicine if he has a lot of pain. Your child may need antibiotic (an-ti-bi-ah-tik) medicine or a tetanus shot if his fracture broke the skin. Caregivers may also want you to use ice packs on your child's fracture to lessen swelling and pain. Ask caregivers how to safely use an ice pack. Caregivers may also suggest physical therapy or exercises to help your child get normal movement back in his hip and leg.
  
  
• Caregivers will also watch for compartment syndrome. Compartment syndrome is pain, swelling, weakness, and decreased blood flow in the muscles of the legs and arms. An x-ray can show when the broken bone(s) is healed.

CARE AGREEMENT:

You have the right to help plan your child's care. To help with this plan, you must learn about your child's health condition and how it may be treated. You can then discuss treatment options with your child's caregivers. Work with them to decide what care may be used to treat your child.

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