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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.

CARE AGREEMENT:

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

RISKS:

  • You may get an infection or bleed more than expected after surgery. Blood vessels, nerves, or muscles may be damaged. Your hip may not heal or work as well as it did before your injury. You may still have pain, a limp when you walk, or need to use a cane or walker.

  • You are at risk for a fat emboli. This is when fat is forced out of the inside of the bone and travels to other parts of your body. It can block blood flow to your lungs, brain, or heart. You may get a blood clot in your arm or leg. This may become life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Before your surgery:

  • Medicines:

    • Anesthesia: This medicine is given to make you comfortable. You may not feel discomfort, pressure, or pain. An adult will need to drive you home and should stay with you for 24 hours. Ask your caregiver if you can drive or use machinery within 24 hours. Also ask if and when you can drink alcohol or use over-the-counter medicine. You may not want to make important decisions until 24 hours have passed.

    • Antibiotics are given to help prevent infections caused by bacteria during or after your surgery.

    • Blood thinners help prevent blood clots. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make it more likely for you to bleed or bruise.

    • Heart medicine may prevent problems such as a heart attack during or after your surgery.

  • Monitoring:

    • A heart monitor will record your heart's electrical activity.

    • Pulse oximeter is a device that measures the amount of oxygen in your blood.

During your surgery:

  • Your healthcare provider will make an incision on your hip to see the damaged femur. He will straighten your femur and put the broken pieces of bone together. He may use metal screws, bars, plates, or rods to hold the broken bones tightly together.

  • Healthcare providers will use an artificial implant to replace the head of your femur, if needed. It will be tightly fitted to the top of your femur. It may be secured using screws or cement. If your hip socket is badly damaged, it may also be replaced with an implant. X-rays may be taken during surgery to help healthcare providers put your hip joint back together. X-rays can also show if the devices and implants are in the right places. A drain may be placed to carry blood and other fluids away from your hip joint. Your incision will be closed with stitches or staples and covered with a bandage.

After your surgery:

You will be taken to a recovery room where you can rest until you are fully awake. Healthcare providers will monitor you closely. When they see that you are okay, you will be moved back to your hospital room. Do not try to get out of bed until your healthcare provider says it is okay. A bandage will be used to cover your stitches or staples and drain. The bandage will help prevent infection. The drain may be removed a day after your surgery.

  • Medicines may be given to reduce pain, nausea, swelling, or fever.

  • Take deep breaths and cough 10 times each hour. This will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath, then let the air out and cough. Repeat these steps 10 times every hour.

  • You may be given exercises to start on the day of surgery, or the day after. You may also be asked to move yourself between your bed and a chair. On the next day, you may be asked to stand and walk while holding onto bars for support. Later you will walk with a walker or cane, and then without a device, if possible. Healthcare providers may also teach you exercises to strengthen the muscles around your hip joint and speed up your recovery. Tell your healthcare provider if you have trouble or pain when you exercise, stand, or walk.

  • You may need to wear inflatable boots after surgery. The boots have an air pump that tightens and loosens different areas of the boots. This device improves blood flow and helps prevent clots.

  • You may need to wear pressure stockings after your surgery. These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You will be told how long to wear these stockings. Ask your healthcare provider for more information.



  • You will be able to drink liquids and eat certain foods once your stomach function returns after surgery. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

© 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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