FAQ's

About Hip Fractures

How is a hip fracture diagnosed?
Your orthopedic physician will X-ray both of your hips to determine exactly where the bone broke and how far out of place the pieces have moved. If the fracture does not show up on X-rays, you might also have to get a MRI (magnetic resonance imaging) scan.

Is there more than one type of hip fracture?
Most hip fractures are one of two types:
*Femoral neck fractures are 1-2 inches from the joint
*Intertrochanteric fractures are 3-4 inches from the joint

How is a femoral neck fracture fixed?
Your Orthopedic surgeon will reposition the fracture and hold it in place with an internal device. Pins (surgical screws) are used if you are younger and more active, or if your broken bone has not moved much out of place. If you are older and less active, you may need a high strength metal device that fits into your hip socket, replacing the head of your femur (hemiarthroplasty).

How is a intertrochanteric fracture fixed?
Your Orthopedic surgeon will reposition the fracture and hold it in place with an internal device. A metallic device (compression screw and side plate) holds the broken bone in place while it lets the head of your femur move normally in your hip socket.

What precautions will I need to take after surgery?
You will need to take the following precautions listed below until your orthopedic surgeon discontinues them:

Do Not place more weight than the surgeon and physical therapist has prescribed on the operative leg.
Do Not cross ankles or knees while sitting, walking, or turning.
Do Not bend the hip greater than 90 degrees.

Do Not sit in low or overstuffed chairs.
Do Not bend over to put on socks or shoes.
Do Not lean forward on the commode.
Do Not raise knee higher than the hip.
Do Not lean forward when attempting to stand from a sitting position.

Do Not turn the foot of the operated hip toward the opposite leg.
Always use an assistive device to walk.
Perform the therapeutic exercises prescribed by the physical therapist.

Who will help me with my exercises?
While in the hospital, the surgeon will most likely order physical therapy services for the patient. A physical therapist is a licensed health professional who assesses, evaluates, and treats the patient to help them achieve mobility and strength. Dependent upon the patient�s medical status, the physical therapist may see the patient once or twice a day during the patients� hospitalization. At Baptist Health Medical Center- Little Rock, the physical therapy department has a satellite location on the third floor. The satellite department is equipped with assistive devices (walkers, canes, crutches) stairs, and parallel bars to help the patient accomplish their goals. It is important for all patients to attend their scheduled therapy sessions to ensure maximum benefits of physical therapy. Also, patients should continue their postoperative exercises as long as they continue to use an assistive device.

What must I be able to do before the doctor discharges me?
You must be able to meet the discharge goals:

To walk independently and safely with an assistive device at least 100 feet.
To be able to get in and out of bed without assistance.
To ascend and descend steps with an assistive device and minimal assistance.
To independently demonstrate the hip precautions.

Who will help with my equipment needs at home?
Before going home, the appropriate assistive device will be obtained for the patient if the patient does not have one. A bedside commode may also be ordered. The physical therapist will review all therapeutic exercises and precautions, answer any questions the patient or patient�s family may have, and help the patient with obtaining further assistance if necessary.

What discharge information will I need to know once I get home?

Walking with assistive devices:

Do Not place more weight on the operated leg than the physical therapist or surgeon has prescribed. The surgeon will tell the patient when it is appropriate to increase the amount of weight on the operated leg.
Use the assistive devices correctly. The correct sequence is:
1. Move walker or crutches forward first.
2. Move operated leg second.
3. Move unoperated leg last.
Ascending and descending stairs with a walker
1. To ascend steps
  1. Back up to step.
  2. Place weight on hands and step up with good (unoperated) leg first.
  3. Bring the operated leg and front legs of the walker to the same level as the Unoperated leg.
  4. Go up one step at a time.
2. To descend steps
  1. Place the front legs of the walker on the first step below the level on which standing.
  2. Place weight on hands as stepping down first with operated leg, then the unoperated leg.
Ascending and descending steps with crutches:
1. To ascend steps
  1. Stand close to the bottom step.
  2. Placing weight on hands, step up first with the unoperated leg, then the Operated leg.
2. To descend steps
  1. Place crutches near the front edge of the step below the level on which standing.
  2. Step down first with the operated leg, then the unoperated leg.

Remember: Up with the good, down with bad.
Helpful Information. Have someone support the front of the walker while ascending/descending steps. Also, move hands to the back of the handles or handgrips to prevent the walker from tipping.

Other guidelines for home:

Continue using the assistive device for 6 weeks. At approximately six weeks after surgery, the surgeon may allow walking with a cane. Place the cane in the hand opposite of the operated leg.
Continue all therapeutic exercises until the surgeon advises otherwise.
After 6 weeks and permission from the surgeon, patients may begin taking short walks, shopping, swimming, and other reasonable activities.
The commode seat should be elevated to prevent bending the hip more than 90degrees.
Follow all hip precautions for 6-8 weeks.
Do Not squat down to pick up objects.
Shower instead of bathing to prevent the hip from bending greater than 90 degrees.
Remove all electrical cords and throw rugs away from walking path.
Use a cart to move items.
Store items within easy reach.
Do Not lift heavy objects
Watch for small pets or objects on the floor.

Activities of Daily Living

Bathing:
Do Not get down into the tub. Standing in the shower or using a bath bench or chair is recommended. To avoid bending over to wash legs and feet, use a long handle bath sponge or a shower hose. Remember to not bend the hip greater than 90 degrees, avoid crossing legs and ankles, and only place the amount of weight on the leg prescribed by the physical therapist or surgeon.

Toileting:
A raised toilet seat or a bedside commode is recommended to prevent the hip from bending greater than 90 degrees. If possible, tilt the commode seat by lowering the front legs of the toilet. A reacher or dressing stick may be needed to assist pulling up clothing.

Dressing:
Do Not bend the hip greater than 90 degrees. Dress while sitting on the side of bed. Use a sock aid and a long handle shoe-horn to assist with the socks and shoes. A dressing stick will help to remove or apply articles of clothing.

Household and Cooking Chores:
Avoid any activities that require stooping. A reacher can assist in obtaining hard to reach objects. Remove all throw rugs. Reorganize the kitchen to make food and utensils more accessible. Store frequently used items within easy reach. Use a rolling cart to transport heavy, large, or several items. Use an apron with pockets. Carry hot liquids in containers with lids. Slide objects on the counter top rather than carrying them.

In conclusion, this information is a reference tool to help educate the patient on basic hip anatomy, types of fractures, and physical therapy services. Please feel free to ask your therapist if you have any further questions or concerns regarding therapy. The staff at Baptist Health Medical Center will do "All Our Best" to provide quality care to guide patients on the road to recovery.