Hip Fracture Fixation with Screws/Pins: A Complete Guide

Introduction to Hip Fracture Fixation

A hip fracture is a serious injury, especially common in older adults due to osteoporosis or falls. Hip fracture fixation with screws or pins is a surgical procedure designed to stabilize broken bones and promote healing. This method is often preferred for certain types of fractures where preserving the natural hip joint is possible.

During the procedure, orthopedic surgeons use metal screws, pins, or plates to hold the fractured bone fragments in place. This allows the bone to heal correctly while maintaining mobility. The goal is to reduce pain, restore function, and prevent complications like joint deformity or long-term immobility.

If you or a loved one is facing hip fracture surgery, understanding the process can ease anxiety and help in making informed decisions. This guide covers everything from diagnosis to recovery, ensuring you know what to expect at every step.

Types of Hip Fractures Treated with Screws/Pins

Not all hip fractures are the same—some respond better to screw/pin fixation than others. The most common types treated this way include:

• Femoral Neck Fractures: Occur just below the ball of the hip joint. If the fracture is non-displaced (bones haven’t shifted), screws may be used to stabilize it.
• Intertrochanteric Fractures: These occur between the femoral neck and the long part of the thigh bone. Surgeons often use a combination of screws and a metal plate for support.
• Stress Fractures: Small cracks in the bone, often seen in athletes or osteoporosis patients. Pins may be used if the fracture risks worsening.

Your surgeon will determine the best approach based on X-rays, CT scans, and the fracture’s severity. Early treatment is crucial to avoid complications like avascular necrosis (bone death due to poor blood supply).

Pre-Surgical Preparation & Diagnostic Tests

Before hip fracture fixation, thorough preparation ensures a smoother surgery and recovery. Here’s what to expect:

Diagnostic Tests:

• X-rays: Confirm the fracture’s location and type.
• MRI/CT Scans: Provide detailed images if X-rays aren’t conclusive.
• Blood Tests: Check for anemia, infection, or clotting issues.

Pre-Surgery Steps:

• Fasting: No food or drink for 6–12 hours before surgery.
• Medication Review: Some drugs (like blood thinners) may need adjustment.
• Physical Exam: Ensures you’re fit for anesthesia (general or spinal).

Your medical team will guide you through pre-op protocols to minimize risks and optimize outcomes.

Step-by-Step Procedure: How Screw/Pin Fixation Works

Hip fracture fixation is typically performed under general or spinal anesthesia. Here’s a breakdown of the process:

1. Incision: A small cut is made near the hip to access the fracture.
2. Bone Alignment: The surgeon repositions the broken bone fragments.
3. Hardware Placement: Screws or pins are inserted to hold the bones in place. Fluoroscopy (live X-ray) guides precision.
4. Closure: The incision is stitched, and a sterile dressing is applied.

The surgery usually takes 1–2 hours, and patients are monitored in recovery before moving to a hospital room. In some cases, partial weight-bearing is allowed soon after surgery.

Benefits & Risks of Hip Fracture Fixation

Benefits:

• Faster Recovery: Compared to hip replacement, fixation often allows quicker mobility.
• Preserves Natural Bone: Avoids removing the hip joint.
• Lower Infection Risk: Less invasive than joint replacement.

Potential Risks:

• Non-Union: Bones may not heal properly, requiring further surgery.
• Hardware Issues: Screws can loosen or irritate surrounding tissue.
• Blood Clots: Immobility increases deep vein thrombosis (DVT) risk.

Your surgeon will discuss personalized risks based on age, health, and fracture type.

Recovery & Rehabilitation Process

Recovery after hip fracture fixation varies but generally follows these stages:

Hospital Stay (3–5 days): Pain management, wound care, and initial physical therapy begin.

First 6 Weeks: Limited weight-bearing with crutches or a walker. Physical therapy focuses on gentle range-of-motion exercises.

3–6 Months: Gradual return to normal activities. Strengthening exercises help restore hip function.

Adhering to rehab plans is critical—skipping therapy can delay healing or reduce mobility long-term.

Post-Surgery Care & Lifestyle Adjustments

To ensure optimal healing:

• Wound Care: Keep the incision clean/dry. Watch for redness or discharge (signs of infection).
• Medications: Take prescribed painkillers and antibiotics as directed.
• Diet: Eat calcium/vitamin D-rich foods (e.g., dairy, leafy greens) to support bone health.
• Fall Prevention: Remove tripping hazards at home. Use assistive devices until fully recovered.

Regular follow-ups with your surgeon track progress and address concerns early.

FAQs About Hip Fracture Fixation

When to Seek Medical Help After Surgery

Contact your doctor immediately if you experience:

• Severe pain not relieved by medication.
• Fever/chills (possible infection).
• Sudden swelling/redness at the incision site.
• Shortness of breath (could indicate a blood clot).

Prompt attention to complications improves outcomes and prevents long-term damage.