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Open Reduction And Internal Fixation Of A Hip Fracture In Children


  • Open reduction and internal fixation of a hip fracture is surgery that is done to repair a broken hip. This surgery is also called ORIF. The femur is the long bone in the thigh that attaches to the hip joint. A hip fracture is a break in the top part of the femur. The top of the femur has a round area called the head of the femur. The head of the femur fits into the acetabulum, which is a cup shaped hollow area in the pelvis. The femur may fracture (break) at any area, including at or below the head of the femur, or along the growth plate. The acetabulum may also break. When the bone is fractured, it may also move out of place (dislocate).
  • A hip fracture can occur from a fall or accident, while playing sports, or as a result of a disease. During ORIF, caregivers move the bone back into place. This is called reduction. When caregivers do the reduction without surgery, it is called closed reduction. When a surgical opening is made, it is called open reduction. Hardware, such as rods, pins, or screws, are placed to hold the broken bone together. This is called internal fixation. After surgery, your child will be in a cast until the bone heals. ORIF surgery may help your child's hip fracture heal, so that he can return to activities that he enjoys.



  • Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.
  • Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.
  • Antibiotics: Antibiotics may be given to help your child fight or prevent an infection caused by germs called bacteria. Give this medicine as ordered until it is all gone. Do not stop giving your child this medicine, even if he is feeling better. Stopping the medicine too early can make the germs resistant (not able to be killed by medicine).
  • Blood thinners: This medicine helps prevent clots from forming in your child's blood. Blood thinning medicine makes it easier for your child to bleed or bruise. Have your child brush his teeth with a soft toothbrush to help prevent his gums from bleeding.
  • Pain medicine: Your child may need medicine to take away or decrease pain. Know how often your child should get the medicine and how much. Watch for signs of pain in your child. Tell caregivers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.

Ask for more information about where and when to take your child for follow-up visits:

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

  • Ask your child's caregiver when your child needs to have x-rays or other tests. These tests may be done to check how your child's bone is healing. If your child has a cast, ask when he needs to have it removed.

Caring for your child's wound and cast:

Ask your child's caregiver how to care for your child's wound (surgery area). Your child may need to have a hip spica cast. This cast is placed around your child's stomach and down his hip and thigh. Your child will be taught how to use the bathroom and take a bath while in the cast. You will learn how to help him do these activities, and how to clean the cast and keep it dry. You will also learn how to help your child move and get dressed.

Hip Spica Casts


Your child may need to use crutches or a cane. He may walk at first only bearing weight on the toes of his injured leg. If he is in a spica cast, he may need to use a wheelchair.

After your child has his cast removed:

Follow caregivers' instructions to help your child avoid injuries. Your child may need physical therapy. A physical therapist will help your child with special exercises. These exercises help make your child's bones and muscles stronger.


  • Your child has a fever.
  • Your child has blood or pus leaking from the surgery wound.
  • Your child has stomach pain or is vomiting (throwing up).
  • You have questions or concerns about your child's injury, surgery, or medicine.


  • Your child has chest pain or trouble breathing that gets worse over time.
  • Your child has a cast and his toes become swollen, cold, or numb (lose feeling). His toes may also look pale (light in color), or blue.
  • Your child has pain that does not go away with medicine or is getting worse.
  • Your child tells you that his leg feels tender or painful. It may feel warm to the touch, and look swollen and red.
  • Your child feels lightheaded, has trouble breathing, or he faints.
  • Your child coughs up blood, has new, sudden chest pain, or has pain when he breathes or coughs.

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Learn more about Open Reduction And Internal Fixation Of A Hip Fracture In Children (Aftercare Instructions)

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