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Hip Nailing for Hip Fracture: Everything you need to know about the procedure

  • Posted on- Aug 06, 2016
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Written by site author.

Hip Nailing is a surgical procedure that involves reconnecting the loose bone fragments of the femur, close to the hip joint. The hip joint is a ball (the head of a thigh bone/femur) and socket (called acetabulum) joint that is covered by a soft tissue envelope called capsule. Any fracture to the socket is not considered a hip fracture. Nailing is performed for hip fracture. There are 3 types of hip fractures:

  • Intracapsular fracture: Fractures at the level of head and neck of femur, within the capsule
  • Intertrochanteric fracture: Fractures that occur between the greater and lesser trochanter (2 different bony prominences on the upper part of femur)
  • Subtrochanteric fracture: Fractures that occur below the lesser trochanter

What are the reasons behind a hip nailing for hip fracture surgical procedure?

A hip nailing for hip fracture surgical procedure is performed for the following reasons:
  • To improve patient’s pain
  • To improve the hip joint’s range of motion
  • And to improve the mobility, in elderly individuals

How a hip nailing for hip fracture surgical procedure is performed?

The hip nailing for hip fracture surgical procedure is performed as follows:
  • The procedure is performed under general or spinal anaesthesia
  • The approach is based on the area of the hip that is broken. It can be done, either through the front, or back of the hip. In some patients, both approaches may be required
  • In cases where fracture fragments are displaced, a reduction of fragments to near normal position is obtained first, either without an incision (closed reduction) or with incision (open reduction)
  • Surgery is performed only when an adequate, stable, or near-anatomic reduction, is obtained
  • A cut is made in the skin on the lateral aspect of the thigh and continued down through the underlying tissues and muscles to the femur
  • The lateral femur and the greater trochanter is exposed
  • A nail is inserted through the greater trochanter, with a compression hip screw inserted through the upper portion of the nail, into the femoral head
  • After appropriate placement of the nail, the muscles, fascia, and skin are closed

An orthopaedic surgeon performs the Hip Nailing for Hip Fracture procedure. Depending on surgeon’s experience and expertise, the surgery may take anywhere between 2-4 hours.

Preparations needed before a hip nailing for hip fracture surgical procedure

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range if not their diabetologist may have to control blood sugar by recommending insulin or a combination of oral medicines

Diagnostic lab tests needed before a hip nailing for hip fracture surgical procedure

Prior to a hip nailing for hip fracture procedure, the patient has to undergo certain tests, such as:

Risks and complications during hip nailing for hip fracture surgical procedure

The possible risks or complications that may arise during the surgery are:
  • Excessive bleeding
  • Infection around the surgical wound
  • Formation of blood clots
  • Anaesthetic complications
  • Accidental injury to the neighbouring tissues

Risks and complications after hip nailing for hip fracture surgical procedure

Post hip nailing for hip fracture procedure, the following complications may arise:
  • Excessive bleeding
  • Infection of the surgical wound
  • Formation of blood clots in the legs that can travel to the lungs (pulmonary embolism)
  • Reoccurring fracture of the hip
  • Non-union of fracture
  • Device failure

Post-operative care needed after a hip nailing for hip fracture surgical procedure

At home, the following post-operative care is recommended, after a hip nailing for hip fracture procedure:
  • Slowly resume daily activities, as advised by the surgeon and physiotherapist, to aid in a faster recovery
  • Individuals usually begin by using a walker, followed by crutches, and then a cane, if needed
  • Avoid all activities that are physically strenuous for about 12 weeks after surgery
  • Avoid lifting or pulling heavy objects
  • Resume driving, when advised by your physician
  • Gently wash the surgical wound everyday with plain soap and water
  • Elevate legs while resting, to prevent formation of blood clots and reduce the possibility of swelling
  • Complete the course of prescribed medication, advised by your physician
  • Blood thinning medication may be prescribed by your physician, to help prevent the formation of blood clots
  • Take stool softeners to prevent constipation, under advice by the physician
  • Take antibiotic medication to help combat or prevent infection, as advised by the physician
  • Avoid taking non-prescription medications, such as aspirin. However, individuals may take acetaminophen to relieve pain, if necessary
  • Immediately for a few weeks after the surgery, have a high-fibre diet. As you increase your fibre intake, also increase your fluid intake, in order to prevent constipation and stress during bowel movements and urination
  • Avoid sex till complete healing has taken place (or follow your physician’s advice)

Comments

user profile image
28-02-2018 07:39 AM

I had this procedure done when I had met with an accident. Post operational results were very fine.

user profile image
24-05-2017 04:15 AM

Great information shared. Keep it up.

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