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ORIF of Hip Fracture
What you need to know about open reduction and internal fixation (ORIF) of a hip fracture:
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.
What will happen during surgery:
- You may be given medicine to keep you asleep and free from pain during surgery. You may instead be given the medicine into your spine to numb the surgery area. You may also receive a medicine to prevent infection. 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.
What will happen after surgery:
You will stay in the hospital for several days. You will need to wear pressure stockings to help prevent blood clots. It will be important for you to get up and move after your surgery. Movement also helps prevent blood clots and pneumonia. A physical therapist will come and help you move the day after surgery. He will teach you how to use a walker or crutches. He will also give you exercises to do when you go home. After you go home, you will need to continue physical therapy.
Risks of surgery:
You may bleed more than expected or develop an infection. You may develop blood clots that can become life-threatening. You may have difficulty walking without assistance of a walker or cane even after surgery.
Call 911 for any of the following:
- You have chest pain when you take a deep breath or cough.
- You suddenly feel lightheaded and short of breath.
- You cough up blood.
Seek care immediately if:
- Your leg feels warm, tender, and painful. It may look swollen and red.
- You fall.
- Blood soaks through your bandage.
- Your wound becomes swollen, red, or has pus coming out of it.
- Your incision comes apart.
Contact your healthcare provider if:
- You have a fever of 100.5 °F (38.1° C).
- You have questions or concerns about your condition or care.
Prevent deep vein thrombosis (DVT):
DVT is a condition that causes blood clots to form inside your blood vessels. This can happen after a major bone surgery. Ask your healthcare provider for more information about DVT. Your healthcare provider may have you wear pressure stockings to promote blood flow and prevent clots. He will give you a prescription for the right stockings for you. Do not buy over-the-counter pressure stockings unless your healthcare provider says it is okay. The stockings may not fit correctly or may have elastic that can cut off your circulation. You will be told how long to wear these stockings.
Check the surgery site for signs of infection, such as redness, swelling, or pus. Change the bandage as often as directed and when it gets wet or dirty. Follow your healthcare provider's instructions on when you can bathe. Gently wash the part of your body that has the stitches. Do not rub on the stitches to dry your skin. Pat the area gently with a towel. When the area is dry, put on a clean, new bandage as directed.
- Increase your calcium and vitamin D intake as directed. Calcium and vitamin D strengthen bones and can help prevent another fracture. Your healthcare provider may tell you to eat more dairy products, such as milk and cheese, for calcium. Spinach, salmon, and dried beans are also good sources of calcium. Cereal, bread, and orange juice may be fortified with vitamin D. You also get vitamin D from exposure to sunlight. Your healthcare provider may also suggest a calcium or vitamin D supplement. Do not take supplements unless directed. Eat high-protein foods to help your surgical wound heal, such as chicken, beef, fish, and pork. Also eat fruits and vegetables.
- Rest as needed. Be careful and go slowly until you have healed. Stop if you have pain during activity. Try to avoid activities that increase your pain.
- Use heat as directed. Heat increase blood flow and helps healing. Heat can also help decrease pain. You can apply heat with an electric heating pad, hot water bottle, or warm compress. Heat should be applied for about 15 to 20 minutes up to 4 times a day and as directed. Always put a cloth between your skin and the heat pack to prevent burns. Check your skin for color changes or blisters about every 5 minutes. Remove the heat if you notice skin changes.
- Use ice as directed. Ice helps decrease swelling and pain. Apply ice for 10 to 15 minutes on your hip up to 4 times a day and as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel before you place it on your skin.
Go to physical therapy as directed:
A physical therapist will teach you exercises to help improve movement and strength of your hip. The therapist may suggest exercising in a pool. The exercises will also help to decrease pain.
Fall prevention is an important part of hip fracture recovery. The following may also help prevent another hip fracture:
- Get regular exercise. Exercise will improve your balance, range of motion, and strength. Ask about the best exercise plan for you.
- Talk to your healthcare provider about all of the medicines you take. Some medicines can cause dizziness or drowsiness and increase your risk for falls.
- Use walking devices , such as canes or walkers, if you have trouble keeping your balance.
- Make your home safe:
- Improve the lighting in your home so that you can see well.
- Add grab bars to the inside and outside of your tub or shower and next to the toilet.
- Add railings to both sides of your stairways.
- Remove throw rugs and other objects that can cause you to trip and fall.
Follow up with your healthcare provider as directed:
You may need to return to have your wound checked and staples or stitches removed. You may need more tests or treatment. Write down your questions so you remember to ask them during your visits.
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