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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.


Before your child's surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that your child 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 child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.
  • Emotional support: Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.
  • An IV is a small tube placed in your child's vein that is used to give him medicine or liquids.
  • Antibiotics: Your child may be given antibiotics to help fight infection. Antibiotics may also be given after your child's surgery.
  • General anesthesia will keep your child asleep and free from pain during surgery. Anesthesia may be given through your child's IV. He may instead breathe it in through a mask or a tube placed down his throat. The tube may cause your child to have a sore throat when he wakes up.

During your child's surgery:

  • An incision will be made so healthcare providers 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 healthcare providers 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. Healthcare providers will monitor him closely. Do not let your child get out of bed until healthcare providers say it is okay.

  • Cast: 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.
  • Activity: Your child may be allowed to walk with crutches if he has a leg cast. He may bear weight on the toes but not the rest of the foot on his injured side.
  • Medicines:
    • 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.
    • Blood thinners: This medicine helps stop clots from forming in your child's blood. Blood thinners may be given before, during, and after a surgery or procedure. Blood thinners make your child more likely to bleed or bruise.


  • 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.


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 healthcare providers to decide what care you want for your child.

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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.

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