Name of the Procedure

Open Treatment of Femoral Fracture, Proximal End, Neck, Internal Fixation or Prosthetic Replacement
Common names: Hip Fracture Surgery, Open Reduction and Internal Fixation (ORIF) of Hip Fracture

Summary

This surgical procedure involves repairing a broken hip bone (femoral neck) either by internally fixing the bone with hardware or replacing it with a prosthetic implant.

Purpose

Medical Condition:

• Hip fracture involving the neck of the femur.

Goals/Outcomes:

• Stabilize the fractured bone.
• Relieve pain.
• Restore mobility and function.
• Promote healing and prevent complications.

Indications

Symptoms/Conditions:

• Severe hip pain.
• Inability to bear weight on the affected leg.
• Visible deformity or abnormal positioning of the leg.
• Confirmed femoral neck fracture via imaging.

Patient Criteria:

• Generally healthy for surgery.
• Fracture pattern amenable to internal fixation or prosthetic replacement.
• Patients who require reliable and quick mobilization.

Preparation

Instructions:

• Fasting for several hours prior to surgery.
• Stopping certain medications (e.g., blood thinners) as instructed by the doctor.
• Arranging transportation and post-operative care.

Diagnostic Tests/Assessments:

• Blood tests.
• Electrocardiogram (EKG).
• Imaging studies (X-ray, MRI, or CT scan).

Procedure Description

1. Anesthesia: General anesthesia or regional anesthesia (spinal or epidural).
2. Incision: A surgical incision is made over the hip.
3. Exposure: Muscles and tissues are carefully moved to expose the fractured bone.
4. Fixation or Replacement:
   • Internal Fixation: Metal screws, pins, or plates are used to stabilize the bone.
   • Prosthetic Replacement: The damaged bone is removed and replaced with a metal or ceramic implant.
5. Closure: The incision is closed with sutures or staples.
6. Dressing: A sterile dressing is applied.

Tools/Equipment:

• Surgical instruments for cutting and fixation.
• Imaging devices for intraoperative guidance.
• Prosthetic components, if replacement is done.

Duration

Typically 2 to 4 hours, depending on the complexity.

Setting

Performed in a hospital operating room.

Personnel

• Orthopedic surgeon.
• Surgical nurses.
• Anesthesiologist.
• Operating room technician.

Risks and Complications

Common Risks:

• Infection.
• Bleeding.
• Blood clots.

Rare Risks:

• Nerve or blood vessel damage.
• Implant failure or loosening.
• Non-union or improper healing of the fracture.

Management:

• Post-operative monitoring.
• Antibiotics and anticoagulants as preventive measures.

Benefits

• Pain relief.
• Restored mobility.
• Improved quality of life.
• Reduced risk of complications from prolonged immobility.

Recovery

Post-Procedure Care:

• Pain management with medications.
• Physical therapy to regain strength and mobility.
• Wound care and monitoring for signs of infection.

Recovery Time:

• Hospital stay: A few days to a week.
• Full recovery: Several months.
• Restrictions: Limited weight-bearing and activity as directed by the surgeon.
• Follow-up: Regular appointments to monitor healing.

Alternatives

Other Options:

• Non-surgical management with traction and bed rest (less effective).
• Minimally invasive pinning (for less severe fractures).

Pros and Cons:

• Non-surgical approaches have a longer recovery and higher risk of complications.
• Minimally invasive options have quicker recovery but may not be suitable for all fracture types.

Patient Experience

During the Procedure:

• Under anesthesia, so no pain or awareness during surgery.

After the Procedure:

• Pain and swelling managed with medication.
• Gradual increase in activity through physical therapy.
• Discomfort and mobility limitations during initial recovery period.