Surgical options include:
- Repair with hardware. The surgeon repositions the two ends of the facture into their normal alignment and inserts metal screws into the bone to hold it in place while the fracture heals. In some cases, screws are attached to a metal plate the runs alongside the femur.
- Partial hip replacement. The surgeon removes the femoral head (the rounded end of the upper thighbone) and replaces it with a metal or ceramic ball that is fixed solidly to a metallic stem inserted into the upper part of the femur. The acetabulum (hip socket) is not replaced.
- Total hip replacement. The surgeon removes the damaged femoral head and replaces it with a metal or ceramic ball that is fixed solidly to a metallic stem inserted into the upper part of the femur. The acetabulum is replaced with a plastic liner fixed into a metal shell.
If the fracture restricts blood supply to the femoral head, the bone is less likely to heal properly. Partial or total hip replacement is usually recommended for these types of injuries.
Anatomy
The hip joint lies between the femur and the pelvis, surrounded by protective muscle and cushioned by rubbery cartilage. It is the largest ball-and-socket joint in your body. The “ball” is the femoral head. The “socket” is a concave depression in the lower side of the pelvis called the acetabulum.
When is surgery recommended?
A hip fracture almost always requires surgical repair or replacement. Some broken bones, such as a broken ankle or broken arm, heal on their own in a cast. But a broken hip is not likely to heal well without surgery.
What is the recovery time?
Recovery time varies depending on the type of procedure you have. Minimally invasive approaches, improved implant material and design, and refined surgical techniques have dramatically reduced recovery time. For these patients, the typical recovery period is now weeks rather than months. Most patients are up and walking immediately following surgery and regain range of motion, strength and flexibility after several weeks of physical therapy. Hospital stays have been reduced to one or two days and the vast majority of patients can go directly home without having to use a rehabilitation center.