Fractures - FAQs

Questions About Fractured Hips

What is a hip fracture?

The hip is a joint where the thigh bone, femur, connects to the pelvis with muscles. A fracture is a break of the thigh bone in the hip area. The exact location of your fracture will help your doctor decide how to repair your hip. Your doctor will discuss this with you before you are taken to surgery.

What are some of the risks and complications?

As with any surgery, there are risks or problems. They may include pneumonia, infection, or blood clots. Your doctor will discuss your risks and answer any questions you and your family may have. It is important to tell your doctor all of your past medical history and all of the medicines you are taking, including over-the-counter drugs.

What will be done before surgery?

You will be seen by the orthopaedic surgeon and a medical doctor. Tests will be done to make sure you are prepared for surgery and to help prevent problems after surgery. These tests may include x-rays of your involved hip, a chest x-ray, an EKG, and blood and urine tests.

When will the surgery be done?

In most cases, surgery is performed within 24 hours of admission. Some medical conditions may delay this.

How will my pain be controlled?

Pain medicine will be ordered for you from the time you are in the Emergency Department throughout your Hospital stay, and even after you leave the Hospital. The pain medicine is ordered on an “as needed basis.” This means the pain medicine is given when you ask for it. It is important to ask for the pain medicine as soon as you feel uncomfortable. Don’t wait until your pain is severe. The medicine will not work as well. The level of your pain should go down over time.

Is post-operative confusion common after surgery?

It is not uncommon for some older patients to be confused for a short time after surgery. The confusion may happen because of a change in environment, the anesthesia, pain medication, or a problem with confusion that was present before surgery. This may last for several days. The healthcare team will work hard at reorienting you and maintaining your safety.

What can I expect after surgery?

Unless you have special medical needs, you will be taken, after surgery, to a room in our Orthopaedics Unit - located on the fifth floor of N-Building. There, nurses will frequently check your temperature, heart rate, breathing, and blood pressure. You will have special stockings and boots on your legs to maintain good blood flow and help prevent blood clots in your legs. Some other devices you may have are oxygen, IV fluids, a urinary catheter (tube draining urine from your bladder), and a drain from your incision. A pillow may be placed between your legs to keep the legs in proper position. The nursing staff will explain these devices to you.

How will I go to the bathroom after surgery?

Most patients return from surgery with a urinary catheter in place. Because of the catheter, you will not need to get up to go to the bathroom or use a bedpan right away. The catheter is most often removed one or two days after surgery. When it is removed, you will use a bedpan or urinal, and use the bathroom when you are able. Many patients are constipated after surgery. This normally improves as you are able to walk more and use less pain medicine. If you have concerns about this, please talk with your nurse or doctor.

Isn’t the first day after surgery too soon to get out of bed?

No. The sooner we get you out of bed, the quicker you will start to get better. It also helps to prevent problems after surgery. The first day after surgery, physical therapy is generally done at your bedside. While you may only be able to walk a few steps, the important this is getting out of bed.

What other kind of therapy can I expect following surgery?

After you have a successful first day, and you are able to sit out of bed one hour or more, your therapy will continue in our Physical Therapy Department. Physical therapy helps make you stronger and able to walk safely for longer distances. Occupational therapists may also work with you to regain your ability to care for yourself. They may help with bathing, dressing, and hygiene, as well as bathroom and kitchen safety.

Will I need special equipment?

Yes. You will need a walker or crutches to help you walk after your surgery. If you have your own walker at home, you may want to use it here. We will check it to make sure it is safe and properly adjusted for you when you go home. It is also important that you have comfortable, rubber-soled walking shoes. Sneakers or athletic shoes are okay. But bedroom slippers are not safe. Depending on the method needed to repair your hip, other special devices may be needed. Your therapist will provide the equipment and tell you how to use it.

How long will I be in the hospital?

Normally, patients with hip fractures remain in the Hospital three to four days after surgery. During this time, the plan for your care when you leave the Hospital will be discussed with you.

What are my discharge options?

If you are already a resident of a skilled nursing facility, you will return there. Otherwise, we will look at how your home is set up, who can help you at home, and how well you are doing in physical therapy. This information will help us decide on the best place for you to go when you leave the Hospital. You may progress well enough to go home. Certain healthcare services in your home, such as visiting nurses, blood draws, and physical therapy, may be arranged if needed. Or, you may need a skilled nursing facility if your recovery is expected to be longer because of health or other issues. This choice provides you with nursing care and physical therapy while you continue to recover. You may decide on a rehabilitation facility. There, you will receive more aggressive therapy - usually three hours a day.

How can I help prevent falls/fractures in the future?

When you get home, develop a plan with your family members to make your living space safer. These are some suggestions:

• Remove scatter rugs.
• Avoid cluttered rooms and hallways.
• Have good lighting.
• If you have a walker or cane, use it. Don't use furniture or walls to help support you.
• Keep wires and cords out of walking path.
• Have secure railings inside and outside. Consider adding them if they are not already installed.
• Consider adapting your bathroom to include non-slip floors, grab bars, and a shower seat.

You should also follow these healthcare tips:

• Eat a balanced diet.
• Exercise with an activity that maintains or improves muscle and bone strength. Talk with your doctor about this first.
• If you are at risk for osteoporosis (bone-thinning disease), talk with your doctor about what else you can do to lessen the risk.

What else do I need to know?

Information about follow-up care, diet, and medications will be discussed with you before you are discharged. Please ask if there is something you do not understand. Once you are discharged, you may still have questions or concerns. Please contact your surgeon’s office, or call 610-988-JOINT.