How Are Hip Fractures Repaired?
Tuesday, September 16, 2014
MICHAEL D. O'BRIEN, MD
Hip fractures are repaired through surgery. The surgical repair really depends on the type of the fracture. One kind of hip fracture is called a subcapital fracture, which occurs in the neck of the femur bone, which is right below the ball of the hip joint. With a subcapital fracture, for example, if the ball of the femur is still in good position, then we insert a few pins to reinforce and heal the bone. If the fracture displaces the ball off the femur, then the blood supply can be interrupted, and that often requires replacing the ball of the femur with an artificial metal one - a procedure called a partial hip replacement (hemiarthroplasty). In this type of repair, the patient can usually walk on it right away after surgery.
Another type of hip fracture is called an intertrochanteric hip fracture, in which the fracture occurs in the bend of the femur. Intertrochanteric fractures are repaired by placing the bones back in their normal position and repairing them with a large screw and plate (called a compression hip screw) or a rod inside of the femur (called a cephalomedullary nail). These will hold the bone together until the fracture heals. In this case, most patients will be allowed to bear weight as soon as they feel comfortable.
In cases where the patient is healthy and active, and thus will be using the hip joint quite extensively, we often consider a total hip replacement, meaning we replace both the ball and the socket.
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