Hip Fracture Repair

What this procedure is

Hip fracture repair is a surgery used to fix a break in the upper part of the thighbone (femur) near the hip joint. Because a broken hip can make it very difficult to move or stand, surgery is often the best way to help the bone heal correctly and safely.

During the procedure, an orthopedic surgeon—a doctor who specializes in bones and joints—uses different tools to stabilize the break. Depending on the location and type of fracture, your clinician may use:

• Internal fixation: Using metal screws, nails, or plates to hold the pieces of bone together while they heal.
• Partial hip replacement: Replacing the "ball" part of the hip joint with a man-made part called a prosthesis.
• Total hip replacement: Replacing both the "ball" and the "socket" of the hip joint with artificial parts.

What it treats or fixes

This procedure treats a hip fracture, which is a serious break in the bone just below the hip joint. These breaks are often caused by a fall or a direct hit to the side of the hip. The surgery aims to put the bone back in its proper place and hold it steady so it can mend.

The main goals of the repair are to:

• Relieve the intense pain caused by the broken bone.
• Allow you to start moving and walking again as soon as possible.
• Prevent health problems that can happen when a person is unable to get out of bed for a long time, such as blood clots or lung infections (pneumonia).

How common it is & where it's done

Hip fracture repair is a very common surgery, especially for older adults whose bones may be weakened by conditions like osteoporosis, a disease that makes bones thin and brittle. Thousands of these procedures are performed every year across North America.

The surgery is performed in a hospital setting. Most patients are admitted through the emergency room after an injury and have surgery within a day or two. After the operation, you will likely stay in the hospital for a few days so the medical team can monitor your recovery and help you start physical therapy.

Once you leave the hospital, your clinician may recommend continuing your recovery at a specialized rehabilitation center or at home with the help of visiting therapists. This helps ensure you regain your strength and mobility safely over several weeks or months.

Recovery: What to Expect

Recovery often begins very quickly. Your clinician may encourage you to get out of bed and sit in a chair or even take a few steps the day after surgery. Moving early helps prevent stiffness and keeps your blood flowing.

• Physical Therapy (PT): A therapist will teach you exercises to strengthen your hip and improve your balance.
• Occupational Therapy (OT): You may learn new ways to perform daily tasks, such as bathing or getting dressed, while your hip heals.
• Pain Management: Your care team will work with you to manage discomfort using medicine so you can participate in your therapy sessions.

Risks & Possible Complications

Every surgery has some risks, but your care team takes many steps to keep you safe. They may use blood thinners or compression stockings (tight socks) to prevent Deep Vein Thrombosis (DVT), which is a blood clot that can form in the leg.

Other risks include infection at the incision site or lung congestion from staying in bed. You should contact your clinician if you notice:

• A high fever or chills.
• Increased redness, swelling, or drainage from the surgical site.
• Sudden pain or swelling in your calf or leg.
• Shortness of breath or chest pain.

Outcomes & Long-Term Results

The main goal of hip repair is to help you return to your normal activities. Many people are able to walk and live independently again after completing their rehabilitation program. Your long-term success often depends on how consistently you follow your exercise plan.

Your clinician may also talk to you about bone health. Treating osteoporosis (a condition where bones become weak or brittle) can help prevent future fractures and keep your new hip repair stable for years to come.

Emotional Support & Reassurance

It is very common to feel frustrated or anxious after a hip fracture. Losing some of your independence, even for a short time, can be difficult. Please remember that these feelings are a normal part of the recovery process.

Having a strong support system of family, friends, and healthcare providers makes a big difference. Your care team is dedicated to your safety and comfort. With patience and steady effort, most patients find they can regain their confidence and get back to the things they enjoy.

Why doctors recommend it

A hip fracture is a break in the upper part of the thigh bone (femur) near the hip joint. Clinicians usually recommend surgery because these types of fractures rarely heal correctly on their own. Without surgical repair, a person may be forced to stay in bed for a long time, which can lead to serious health issues.

By stabilizing the bone through surgery, doctors can help patients avoid complications related to immobility. These may include blood clots in the legs or lungs, pressure sores (skin breakdown from sitting or lying too long), and pneumonia (a lung infection). Your clinician may recommend surgery to reduce pain and help you regain the ability to move safely.

Urgent vs planned treatment

Surgery for a hip fracture is typically treated as an urgent matter rather than a planned, elective procedure. In most cases, clinicians aim to perform the surgery within 24 to 48 hours of the injury. Getting to the operating room quickly is often linked to better recovery and a lower risk of complications.

While the procedure is urgent, your medical team may take a short time to stabilize your overall health before starting. This process, sometimes called "optimization," involves checking for other medical concerns like heart issues or dehydration. Once your condition is stable, the surgery is performed as soon as possible to get you on the path to recovery.

Goals of treatment

The primary goal of hip fracture repair is to fix the break so the bone can support your weight again. Depending on the location and severity of the break, your clinician may use one of the following methods:

• Internal fixation: Using metal screws, plates, or rods to hold the bone together while it heals.
• Partial or total hip replacement: Replacing parts of the hip joint with artificial components (prostheses) if the bone cannot be easily repaired.

Another major goal is to help you start moving as soon as possible, often the day after surgery. Early movement helps maintain muscle strength and prevents joint stiffness. The ultimate success of the treatment is measured by your ability to return to your usual activities and maintain your independence.

Who may benefit

Most people who experience a hip fracture—a break in the upper part of the thigh bone near the hip joint—will benefit from surgery. The primary goal of the procedure is to stabilize the bone so that you can begin moving again as soon as possible. Your clinician may recommend surgery to help reduce pain and prevent serious complications that can happen when a person is confined to bed for a long time, such as blood clots or lung infections.

The type of surgery depends on where the bone is broken and the health of the joint. Some patients may benefit from internal fixation, where a surgeon uses metal screws, nails, or plates to hold the bone together while it heals. Others may need a hip replacement, which involves replacing part or all of the hip joint with artificial parts. This is often recommended if the blood supply to the bone was damaged during the break.

When it may not be the right option

While surgery is the standard treatment for most hip fractures, it may not be the right choice for everyone. Your care team may suggest non-surgical treatment if a person is too ill to safely receive anesthesia (the medicine used to keep you from feeling pain during surgery). If the risks of the procedure outweigh the potential benefits to the patient's quality of life, the focus may shift to comfort and pain management.

In some cases, if a person was unable to walk before the injury occurred, the care team might decide that the stress of surgery is not necessary. Additionally, very stable fractures that are already showing signs of healing on their own might occasionally be managed with bed rest and close monitoring, though this is less common because of the risks associated with staying immobile for long periods.

Questions to ask your care team

Deciding on the best path forward involves a conversation with your doctors. You may want to bring a list of questions to help you understand the plan for recovery:

• Based on the location of the break, which type of surgery do you recommend?
• What are the specific risks and benefits for me, given my overall health?
• How soon after the surgery will I be expected to stand or walk?
• What kind of physical therapy (exercises to improve movement and strength) will I need during my recovery?
• Will I be able to return home after the hospital, or will I need to stay in a specialized rehabilitation center?
• How will my pain be managed both in the hospital and once I am discharged?

In the procedure room

When you arrive in the procedure room, the surgical team will help you onto a specialized operating table. This table is designed to help the surgeon position your leg correctly to reach the bone. The team will clean the skin around your hip with a germ-killing solution and cover the area with sterile cloths to keep the site clean.

The room is kept cool and will contain various monitors and equipment. You will meet your surgical team, including the surgeon, nurses, and the anesthesia provider, who will ensure you are comfortable before the procedure begins.

High-level steps

The surgeon will make an incision (a surgical cut) over the side of your hip. The goal is to reach the broken bone and put the pieces back into their proper place. This process is called reduction.

• Internal Fixation: If the bone can be repaired, the surgeon may use metal screws, plates, or a long rod that goes down the center of the bone to hold the pieces together.
• Hip Replacement: If the break is in a spot where the bone might not heal well, the surgeon may replace the "ball" of the hip joint or the entire joint with an artificial part called a prosthesis.

Once the bone is secure, the surgeon will close the incision with stitches or staples and apply a sterile bandage.

Anesthesia and pain control

Your clinician may use different types of anesthesia to keep you comfortable. General anesthesia puts you into a deep sleep so you do not feel anything during the surgery. Alternatively, regional anesthesia (like a spinal or epidural) numbs you from the waist down while you remain relaxed or lightly asleep.

To help with pain after the surgery, the team may perform a nerve block. This involves injecting numbing medicine near the nerves in your hip or groin. This can help reduce the amount of pain medicine you need as you begin your recovery.

Monitoring and safety steps

Your safety is the top priority during the procedure. The care team monitors your heart rate, blood pressure, and oxygen levels continuously. They also track the amount of fluids in your body to keep you stable.

The surgeon often uses a special real-time X-ray machine called a fluoroscope. This allows them to see the bone and the placement of any metal hardware on a screen during the surgery. This ensures that everything is aligned correctly before the procedure is finished.

Immediately after the procedure

After the surgery is finished, you will be moved to a recovery room, often called the PACU. Nurses will watch you closely as the anesthesia wears off. You may feel groggy, chilly, or have a dry mouth as you wake up.

You might notice some numbness or a dull ache in your hip. The staff will check the sensation and movement in your feet and legs. They will also begin managing your pain right away to make sure you are as comfortable as possible before you are moved to your hospital room.

Typical procedure length

A hip fracture repair typically takes between 1 and 3 hours. The exact time depends on the location of the break and the type of repair needed. Your surgical team will provide updates to your family or loved ones during this time.

Common approaches (open vs minimally invasive)

Your surgeon will recommend a repair method based on the location of the break and how severe it is. The main goal is to hold the bone in place so it can heal or to replace damaged parts to restore movement.

Internal repair: If the broken bone ends can be lined up properly, your doctor may insert metal screws, rods, or plates to hold them together. This hardware stays inside the body while the bone heals.

Open vs. less invasive techniques: Sometimes, a surgeon must make a larger incision (cut) to clearly see the bone and move the pieces back into the right position. In other cases, they may be able to use smaller incisions and special tools to place screws or nails. The choice depends on the type of fracture and what will provide the most stability.

Partial vs total

When the upper part of the thighbone is broken, simply fixing the bone may not be enough. In these cases, your care team may suggest replacing parts of the hip joint with artificial materials. This is often called hip replacement or arthroplasty.

• Partial hip replacement: This procedure replaces only the ball at the top of the thighbone. The natural hip socket is left in place. This is often chosen for adults who have healthy hip sockets or may not be as active.
• Total hip replacement: This surgery replaces both the ball and the socket. It is often considered for people who were very active before the injury or who already have arthritis in the hip joint.

Your clinician will look at your age, daily activity level, and the condition of your joint to decide which option is safest for you.

Revision or repeat procedures

Most hip fracture repairs heal well, but in some cases, a second surgery may be needed. This is known as a revision procedure. It might be necessary if the bone does not heal completely or if the metal hardware loosens, breaks, or becomes infected.

Revision surgeries are generally done to relieve pain and improve function if the first repair does not work as planned. Your doctor will use X-rays and follow-up visits to monitor your healing and decide if further treatment is required.

Tests and imaging that may be done

Because a hip fracture is often an urgent medical event, your care team will quickly run tests to confirm the diagnosis and check your overall health. The most common imaging test is an X-ray of the hip and pelvis. This helps the surgeon see the location and type of break.

If you have hip pain after a fall but the X-ray does not show a clear fracture, your clinician may order more detailed imaging. This might include:

• MRI (Magnetic Resonance Imaging): A scan that uses magnets and radio waves to show detailed images of the bone and soft tissue.
• CT Scan (Computerized Tomography): A series of X-rays taken from different angles to create a cross-section view of the hip.

Before surgery, you will also undergo standard health checks to make sure you are ready for anesthesia. These often include blood tests, a chest X-ray to check your lungs, and an electrocardiogram (ECG) to record your heart rhythm.

Medication adjustments

Your care team will review all the medications, vitamins, and supplements you currently take. It is very important to tell them about everything you use, especially if you take blood thinners (anticoagulants) or anti-inflammatory drugs (like aspirin or ibuprofen), as these can increase bleeding risk.

Only stop medicines if your clinician instructs you. Since hip fracture surgery is usually done within 24 to 48 hours of admission, your doctors will manage your medications directly in the hospital. They may:

• Pause blood thinners or give you a different medication to reverse their effects.
• Adjust insulin or other diabetes medications if you are not eating before surgery.
• Provide pain relief medication intravenously (through an IV) or orally to keep you comfortable while you wait for the procedure.

Day-before and day-of instructions

Since hip fracture repair is typically an urgent surgery rather than a scheduled elective procedure, your preparation usually happens in the hospital room shortly after you are admitted. Your care team will focus on stabilizing your health to ensure surgery is safe.

Common steps leading up to the operation include:

• Fasting: You will likely be asked not to eat or drink anything for several hours before the surgery. This helps prevent complications during anesthesia.
• Hygiene: A nurse may help you wash the hip area with a special antiseptic soap to reduce the risk of infection.
• Anesthesia consultation: You will meet with an anesthesia specialist to decide on the best option for you. This may be general anesthesia (where you are asleep) or spinal anesthesia (which numbs the lower half of your body).

General surgical risks

As with any major operation, hip fracture repair carries certain general risks. Your surgical team takes many precautions to lower the chance of these occurring. One of the most common concerns is the risk of infection, which can happen at the incision site or deeper near the joint. To help prevent this, antibiotics are typically given before and after the procedure.

Because hip surgery limits how much you can move for a short time, there is a risk of blood clots forming in the leg veins. This is known as deep vein thrombosis (DVT). If a clot travels to the lungs, it is called a pulmonary embolism. Your doctor will likely prescribe blood-thinning medication and use special compression stockings to keep your blood flowing safely.

Other general risks include reactions to anesthesia or blood loss that may require a transfusion. Additionally, staying in bed for long periods can increase the risk of pneumonia or skin sores (pressure ulcers), which is why nurses and therapists will help you start moving as soon as it is safe.

Procedure-specific complications

There are specific issues related to how the hip bone heals or how the metal implants function. In some cases, the broken bone may not knit together completely (nonunion) or may heal in a position that is not perfectly aligned (malunion). Sometimes, the metal screws, plates, or rods used to hold the bone in place can shift, break, or cause irritation.

If the blood supply to the ball of the hip joint (femoral head) was damaged during the fracture, the bone tissue may weaken and die over time. This condition is called avascular necrosis. It is more common with certain types of fractures inside the hip capsule.

For patients who receive a partial or total hip replacement rather than a repair of the bone, there is a risk of the new joint popping out of the socket (dislocation). Some patients may also notice a slight difference in leg length after surgery, which can usually be managed with a shoe insert.

How complications are treated

Most complications can be managed effectively if they are caught early. Infections are generally treated with antibiotics, though deep infections may require a procedure to clean the area. If blood clots are detected, doctors adjust blood-thinning medications to help dissolve them and prevent further issues.

If the bone does not heal properly or if the metal hardware fails, your clinician may recommend a second operation, known as revision surgery. This might involve replacing the hardware or converting a repair into a total hip replacement to restore function and reduce pain.

Rehabilitation is a key part of treatment. Physical therapy helps resolve stiffness and prevents complications related to immobility. Your care team will use follow-up X-rays and appointments to monitor the bone’s healing and ensure the hip joint remains stable.

Pain control medicines

Managing your comfort is a top priority after hip surgery. When your pain is well-controlled, it is easier for you to begin moving and start physical therapy. Your clinician may use a combination of different medicines to target pain in various ways. This approach often helps reduce the need for any single type of medicine.

Common options include acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen. These help reduce swelling and soreness. In some cases, your clinician may prescribe stronger pain relievers, often called opioids, for a short period. They might also use local anesthetics, which are medicines that numb a specific area of the body, to help block pain signals near the hip.

Your care team will tailor this plan to your health history. It is important to tell your clinician about any allergies or other medicines you are taking to avoid safety concerns or drug interactions.

Antibiotics

To help prevent an infection at the site of your surgery, your care team will likely give you antibiotics. These are medicines used to kill or stop the growth of harmful bacteria. Preventing infection is a key step in ensuring your hip heals properly.

These medicines are usually started just before your surgery begins and may continue for a short time afterward. They are often given through an IV, which is a small tube placed in a vein. Your clinician will check your medical records for any history of antibiotic allergies before choosing the right medicine for you.

Blood thinners and clot prevention

After a hip fracture and surgery, the body is at a higher risk for developing blood clots in the legs. This condition is sometimes called deep vein thrombosis. To help prevent this, your clinician may prescribe blood thinners, also known as anticoagulants. These medicines help keep your blood from forming dangerous clots while you are less active during recovery.

There are several types of blood thinners, including pills or small injections under the skin. Your clinician will decide which type is best for you and how long you should take it. While taking these medicines, your care team will monitor you closely to ensure you do not have excessive bruising or bleeding. They will also encourage you to move your ankles and walk as soon as possible to help your circulation.

Emergency warning signs

While recovering from hip fracture surgery, certain symptoms require immediate attention. These may indicate a serious complication, such as a blood clot traveling to the lungs (pulmonary embolism) or a heart issue.

Call 911 or go to the nearest emergency room if you experience:

• Sudden shortness of breath or difficulty breathing.
• Sudden chest pain or pressure.
• Coughing up blood.
• Severe confusion or a sudden change in mental state.

Call your surgeon or clinic if…

Other symptoms may not require an ambulance but still need prompt medical evaluation to prevent setbacks like infection or deep vein thrombosis (a blood clot in the leg).

Contact your healthcare provider right away if you notice:

• Signs of infection: A fever higher than 100.4°F (38°C), shaking chills, or increased redness, heat, and swelling around your incision.
• Wound drainage: New or worsening fluid leaking from the surgical site, especially if it is green, yellow, or smells bad.
• Signs of a leg blood clot: Pain, tenderness, or swelling in your calf or thigh that does not go away with rest and elevation.
• Uncontrolled pain: Pain that is not relieved by your prescribed pain medication or rest.

Expected vs concerning symptoms

Recovery takes time, and it is normal to feel some discomfort as your body heals. Knowing the difference between normal healing and a potential problem can help you stay calm.

Most people have:

• Bruising and swelling: It is common to see bruising around the hip and thigh. Mild swelling in the leg is also expected, especially after standing or walking.
• Stiffness: The hip joint may feel stiff, particularly in the morning or after sitting for a while.
• Fatigue: Feeling tired is a normal part of healing after major surgery.

Call if you notice:

• Worsening pain: Pain should generally improve over time. If it suddenly gets worse or makes it impossible to put weight on the leg, let your care team know.
• Skin breakdown: Watch for red, sore spots on your heels or tailbone, which could be the start of pressure ulcers (bedsores).
• Leg changes: If the operated leg appears shorter than the other or turns outward abnormally, this requires medical checks to ensure the hip is stable.

Non-surgical treatments

In some cases, your clinician may suggest managing a hip fracture without surgery. This approach is often reserved for people who are very ill or those who were not able to walk before the injury occurred. It may also be an option for certain "stable" fractures, which are breaks where the bone pieces have not moved out of place.

Non-surgical care typically involves:

• Pain management: Using medications to keep you comfortable while the bone heals.
• Bed rest: Staying in bed for a period of time to prevent the bone from moving.
• Physical therapy: Gentle exercises to maintain strength in other parts of the body without putting weight on the hip.

Watchful waiting

Watchful waiting is a process where your medical team closely monitors your recovery without immediate surgery. Your clinician may use regular X-rays to see if the bone is healing correctly or if the pieces are shifting. This helps them decide if the current treatment plan is working.

During this time, the focus is on keeping you stable and comfortable. If the fracture remains in a good position and your pain is controlled, your team may continue with this cautious approach. However, they will stay alert for any signs that the bone is not knitting back together as expected.

When surgery becomes the best option

For most people, surgery is the preferred way to treat a hip fracture. The main goal of surgery is to help you get out of bed and moving as soon as possible. Your clinician may recommend surgery if the risks of staying in bed for a long time outweigh the risks of the procedure itself.

Surgery often becomes the best choice when:

• Mobility is a priority: Getting back to walking helps prevent complications like blood clots or pneumonia (a serious lung infection).
• The fracture is unstable: If the bones have shifted, surgery can help line them up so they heal properly.
• Pain is severe: Fixing the bone with hardware can often reduce pain more quickly than bed rest alone.

Hospital services that commonly perform this surgery

Hip fracture repair is usually performed in hospitals that have a dedicated orthopedic surgery department. This department specializes in treating injuries to the bones, joints, and muscles. Because hip fractures often happen suddenly, the process typically begins in the Emergency Department, where the medical team stabilizes the patient before surgery.

A multidisciplinary team often manages your care to ensure the best results. This team may include orthopedic surgeons, anesthesiologists (specialists who manage pain and sedation), and geriatricians, who are doctors focused on the health of older adults. These specialists work together to manage the surgery and any other health conditions you may have.

Patient resources and support services

Recovery involves more than just the surgical procedure. Hospitals often provide access to physical therapy (PT) and occupational therapy (OT). Physical therapy focuses on helping you regain strength and the ability to walk, while occupational therapy helps you learn how to safely perform daily tasks, like dressing or bathing, during your recovery.

Social workers and case managers are also key resources. They can help you and your family plan for the next steps after leaving the hospital. This may include arranging for a stay at a skilled nursing facility, a dedicated rehabilitation center, or organizing home health services and medical equipment to help you stay safe at home.

Questions for choosing where to have surgery

While hip fractures are often emergencies, understanding the capabilities of a facility can help you feel more confident in the care provided. You or your family may want to ask the following questions:

• How many hip fracture repairs does this hospital perform each year?
• Is there a specialized team available to manage the needs of older patients?
• How soon after surgery does physical therapy typically begin?
• Does the hospital have a dedicated coordinator to help with discharge planning and rehabilitation?
• What support services are available to help manage pain and mobility after I go home?

Conditions commonly treated by this procedure

Hip fracture repair is a surgical treatment used to fix a break in the upper part of the thighbone, also known as the femur. These fractures typically occur near the hip joint, where the thighbone meets the pelvis. Your clinician may recommend this procedure if you have a break in the "neck" of the femur or in the area just below the joint.

This surgery is often associated with osteoporosis, a condition that causes bones to become weak and brittle. While a fall is the most common cause, people with very weak bones may experience a fracture from everyday activities. The goal of the procedure is to stabilize the bone so that it can heal properly and allow for a return to movement.

Related symptoms people search for

If you or a loved one has suffered a hip injury, you may notice several common symptoms. These signs can vary depending on the location and severity of the break, but they often include:

• Severe pain in the hip or the groin area.
• An inability to put weight on the leg or stand up after a fall.
• Bruising, swelling, or redness around the hip area.
• The leg on the injured side appearing shorter than the other leg.
• The injured leg turning outward in an unusual position.

It is important to seek medical evaluation if these symptoms occur. A clinician may use physical exams and imaging tests to determine if a fracture is present and if surgery is the right course of action for recovery.

Evidence overview

Medical research strongly supports surgery as the standard treatment for most hip fractures. Evidence shows that repairing the hip allows patients to move sooner, which helps prevent serious complications associated with long-term bed rest. Clinical guidelines typically recommend performing surgery as soon as possible—often within 24 to 48 hours—once the patient is medically stable. This approach is linked to better recovery outcomes and shorter hospital stays.

The specific type of surgery chosen is based on established medical standards for different types of fractures. For some breaks, evidence supports using metal screws or rods to hold the bone together (internal fixation). For others, replacing the ball of the hip joint (hemiarthroplasty) or the entire joint (total hip replacement) is the recommended path. Rehabilitation is also a key part of the evidence-based protocol, with studies showing that early physical therapy improves the chances of walking independently again.

Safety notes and individualized care

While hip fracture repair is a common and often necessary procedure, it carries risks like any major surgery. Potential complications can include infection, blood clots, or reactions to anesthesia. To improve safety, your care team will likely prescribe blood-thinning medication and special stockings to prevent clots. They will also monitor your heart and lungs closely throughout your hospital stay.

Your treatment plan is tailored to your specific needs. Surgeons look at the location of the break, your age, and your overall health before deciding on the best approach. For example, an active older adult might receive a total hip replacement to ensure long-term function, while a patient with more complex health issues might have a different repair to minimize surgical time. In rare cases where a patient is too ill for surgery, the medical team may recommend managing the fracture with bed rest and pain management, though this is not the standard choice.

Sources used

The information provided is grounded in current medical guidelines and research. Reputable sources used to inform this content include:

• Major academic medical centers and research hospitals.
• Professional medical manuals and rehabilitation guides used by clinicians.
• Peer-reviewed medical summaries and government health databases.