Hip fracture: a new hip joint

Types

• Completely displaced
• Partly displaced

What is broken

The neck of the thigh bone, just below the ball of the hip joint, has broken and the pieces have moved. Here the blood supply to the ball is often torn, so the ball itself may die off even if it is fixed.

Why an operation

Left alone, this fracture almost never heals and walking stays impossible or very painful. Replacing the broken ball allows you to stand up and walk in the first days after the operation.

How the operation is done

Through a cut at the side or the back of the hip, the surgeon removes the broken ball and neck. A metal stem is fixed in the thigh bone and carries a new ball. Depending on your age and activity, only the ball is replaced (half hip) or the socket in the pelvis too (total hip). It usually takes one to two hours.

Anaesthesia and the hospital stay

You will be asleep (general anaesthesia) or numb from the waist down (spinal anaesthesia). Most people stay in hospital about a week, then go home or to a rehabilitation clinic.

Possible risks

• Dislocation: the new ball slips out of its socket — about 2 to 5 in 100, mostly in the first weeks
• Wound or joint infection — about 1 to 2 in 100
• Serious general illness (heart, lungs) that can be life-threatening, mainly in frail people — not rare after a hip fracture; your doctor will discuss your own risk
• Blood clot in the leg or lung — about 1 in 100, despite the injections that prevent it
• Fracture of the bone around the stem — about 1 to 2 in 100
• A small difference in leg length — possible; usually not noticeable
• Nerve injury (numbness or weakness of the foot) — rare, less than 1 in 100

After the operation

You may usually put full weight on the leg straight away. For the first weeks avoid bending the hip very far, crossing the legs and very low chairs, as the physiotherapist will show you. The stitches or clips come out after about two weeks. The new joint normally lasts many years.

Questions people often ask