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ORIF of a Hip Fracture in Children


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 healthcare providers 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.



  • Blood thinners: Blood thinners are medicines that help prevent blood clots from forming. Clots can cause strokes, heart attacks, and death. Blood thinners make it more likely for your child to bleed or bruise. Do the following if your child is taking a blood thinner:
    • Watch for bleeding from your child's gums or nose. Watch for blood in his urine and bowel movements. Use a soft washcloth on his skin and a soft toothbrush on his teeth. This can keep his skin and gums from bleeding.
    • Tell your child's dentist and other healthcare providers that he takes blood-thinning medicine. He should wear or carry a medical alert information that says he is taking this medicine.
    • Give your child this medicine exactly as his healthcare provider tells you. Tell your child's healthcare provider right away if he forgets to take the medicine, or if he takes too much. Your child may need to have regular blood tests while on this medicine. Your child's healthcare provider uses these tests to decide how much medicine is right for him.
    • Talk to the healthcare provider about your child's diet. This medicine works best when he eats about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and other foods, such as cooked peas and kiwifruit.
  • 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 healthcare providers if his pain continues or gets worse. To prevent falls, stay with your child to help him get out of bed.
  • Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
  • Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.

Follow up with your child's healthcare provider as directed:

Your child may need to return to have his stitches, staples, or cast removed. He may also need x-rays or other imaging tests to check for bone healing. Write down your questions so you remember to ask them during your visits.

Wound and cast care:

Ask how to care for your child's wound. If your child has a hip spica cast, he will be taught how to use the bathroom and take a bath. 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 Cast


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

Physical therapy:

Your child may need physical therapy after his cast is removed. A physical therapist teaches your child exercises to help improve movement and strength, and to decrease pain.

For more information:

  • American Academy of Orthopaedic Surgeons
    6300 North River Road
    Rosemont , IL 60018-4262
    Phone: 1- 847 - 823-7186
    Web Address:

Contact your child's healthcare provider if:

  • Your child has a fever.
  • Your child has blood or pus leaking from the surgery wound.
  • Your child has stomach pain or is vomiting.
  • You have questions or concerns about your child's condition or care.

Seek care immediately or call 911 if:

  • Your child has chest pain or trouble breathing.
  • Your child has a cast and his toes become swollen, cold, or numb. His toes may also look pale or blue.
  • Your child has pain that does not go away with medicine or gets 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.

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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.