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Orif Of A Hip Fracture In Children


What is open reduction and internal fixation (ORIF) of a hip fracture?

  • 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 bones together.
  • A hip fracture is a break in the top of the femur or in the hip socket. The femur is the long bone in the thigh that attaches to the hip joint. The top of the femur has a round area called the head of the femur. The head of the femur fits into the hip socket in the pelvis.

What happens during my child's ORIF surgery?

  • Your child will be given medicine called general anesthesia to keep him asleep during surgery. An incision will be made on your child's hip so the healthcare provider 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 used to hold the bone in the correct place. X-rays may be used during surgery to check the hardware placement.

What happens after my child's ORIF surgery?

  • 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 bar holds his bones and joint in place so they can heal.
    Hip Spica Cast
  • Healthcare providers will work with you and your child so that his leg movements will slowly increase over time. Your child may be in a cast for up to 8 weeks, after which he may begin physical therapy. Ask healthcare providers if and when your child may need to have his hardware removed.

How do I care for my child after his ORIF surgery?

  • Activity: If your child is in a hip spica cast, he may need to use a wheelchair. If your child has a cast on one leg, he may need to use crutches. Your child may not be able to return to his usual activities for a few months after surgery. He may need to wait until his bone has healed completely before playing sports. Ask your child's healthcare provider to explain what activities your child can do as his hip is healing. Ask when he may return to school.
  • Cast care: Ask healthcare providers how to help your child bathe and use the bathroom. Ask healthcare providers for more information about how to take care of your child's cast.
  • Pain medicine: Your child may be given medicine to take away or decrease pain. Do not wait until the pain is severe before you give your child his medicine.

What are the risks of ORIF surgery?

  • 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.

Where can I find more information?

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

When should I contact my child's healthcare provider?

Contact your child's healthcare provider if:

  • Your child has a fever.
  • Your child has blood or pus leaking from the fracture or surgery wound.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • 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. 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, he is short of breath, or he faints.
  • Your child coughs up blood, has new, sudden chest pain, or has pain when he breathes or coughs.

Care Agreement

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 caregivers to decide what care you want for your child. 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.

© 2016 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.