Hip Fracture Repair (ORIF/hemiarthroplasty) Orthopedic Surgery

Hip fracture repair is surgery to fix a broken hip.

Hip Fracture Repair (ORIF/hemiarthroplasty) procedure illustration

Overview

Hip fracture repair is surgery to fix a broken hip. It is most often done using ORIF or hemiarthroplasty. ORIF means open reduction and internal fixation. The surgeon makes an incision, lines up the broken bone, and secures it with plates, screws, or a rod. Hemiarthroplasty means replacing the broken ball part of the hip joint with an artificial implant. These operations aim to reduce pain, stabilize the bone, and help people sit, stand, and walk sooner. Repair is often recommended because staying in bed with a broken hip can lead to problems like blood clots, pneumonia, and pressure sores.

Overview Preparation Clinical Info Recovery FAQ References

Also known as: Hip fracture surgery, ORIF hip, Hip hemiarthroplasty, Partial hip replacement, Open reduction internal fixation of hip

Recovery
42–180 days
Return to Work
28–90 days

Preparation & Next Steps

Everything you need to know before and after your procedure

Before Care

  • Expect imaging such as X-rays or a CT scan to define the fracture pattern
  • Discuss the plan for ORIF versus hemiarthroplasty and why one is recommended
  • Review health history, allergies, and all medicines, including blood thinners and supplements
  • Talk with anesthesia about options such as spinal or general anesthesia
  • Follow hospital fasting instructions before surgery, often nothing to eat or drink after midnight
  • Ask about infection prevention steps such as pre-op showers, skin prep, or nasal swabs
  • Arrange a support person for consent, updates, and help during the hospital stay
  • Plan for discharge needs such as home help, a walker, or short-term rehab placement
  • Prepare the home by removing trip hazards and setting up a safe sleeping and bathroom area
  • Bring photo ID, insurance information, and a complete medication list

After Care

  • Keep the incision area clean and dry and follow the dressing change plan given by the care team
  • Take pain medicines only as instructed by your clinicians and store them safely
  • Use prescribed blood clot prevention methods such as blood thinners or compression devices
  • Start physical therapy and practice safe transfers and walking with a walker or cane as instructed
  • Follow any hip precautions taught by your team to lower dislocation risk after arthroplasty
  • Do home exercises to build strength and balance as provided by therapy
  • Use simple measures to manage swelling, such as leg elevation and cold packs if approved
  • Maintain good hydration, fiber, and activity to reduce constipation related to pain medicines
  • Watch for concerning signs and contact the care team if you notice fever, worsening pain, redness, drainage, calf swelling, chest pain, shortness of breath, or new confusion
  • Attend all follow-up visits and any scheduled X-rays and bring your medication list

Clinical Information

Important medical details about this procedure

Indications

  • Displaced femoral neck fracture
  • Unstable intertrochanteric or subtrochanteric fracture
  • Hip fracture with pain and inability to bear weight
  • Failure of non-surgical management
  • Pathologic hip fracture from weakened bone
  • Fracture patterns likely to displace without fixation

Alternatives

  • Total hip arthroplasty for selected femoral neck fractures
  • Percutaneous pinning for some nondisplaced fractures
  • Non-surgical management with pain control and limited mobility in select cases
  • Short-term traction or immobilization
  • Comfort-focused or palliative care when surgery is not aligned with goals

Risks

  • Infection at the incision or deep in the joint
  • Bleeding or need for blood transfusion
  • Blood clots in the legs or lungs
  • Anesthesia-related problems
  • Dislocation of the hip after arthroplasty
  • Hardware irritation or failure
  • Nonunion or malunion of the fracture
  • Avascular necrosis of the femoral head
  • Nerve or blood vessel injury
  • Leg length difference or gait changes
  • Delirium or confusion after surgery
  • Pressure sores or pneumonia during recovery

Contraindications

  • Severe medical instability that makes anesthesia unsafe
  • Active infection at or near the surgical site
  • Uncorrected bleeding disorders
  • Situations where goals of care do not include surgery

Recovery Timeline

What to expect during your recovery

Hospital stays are often a few days, followed by home health or short-term rehab. Walking usually begins soon after surgery with a device. Many people improve over 6 to 12 weeks, with strength and function continuing to recover for several months.

Typical Range

42–180 days

Return to Work

28–90 days

Recovery Milestones

Day 0–3

Sit up, transfer to a chair, and begin standing with assistance

Day 1–7

Walk short distances with a walker under supervision

Day 7–14

Practice stairs with a handrail and continue daily home exercises

Day 14–42

Increase walking distance; transition to a cane when safe

Day 42–90

Resume light household tasks and community walking as tolerated

Day 90–180

Build endurance and strength for usual routines

Frequently Asked Questions

Common questions and expert answers about this procedure

What is the difference between ORIF and hemiarthroplasty?

ORIF realigns the broken bone and holds it with metal hardware. Hemiarthroplasty replaces the broken ball of the hip joint with an implant.

How long will I stay in the hospital?

Many people stay a few days. Some go home with services, while others transfer to a short-term rehab facility for therapy.

When can I put weight on my leg?

Early standing and walking are common after surgery, often with a walker. The exact plan depends on the fracture and repair method.

What type of anesthesia is used?

Hip fracture surgery is commonly done with spinal or general anesthesia. The anesthesia team reviews options and safety with you.

Will I need a blood transfusion?

Some people need a transfusion due to blood loss from the fracture or surgery. The care team monitors blood counts and treats if needed.

What complications should I know about?

Infection, blood clots, dislocation after arthroplasty, hardware problems, and failure of the bone to heal can occur, though many people recover well with therapy.

What equipment might I use at home?

Common items include a walker, raised toilet seat, shower chair, and reacher or grabber. A therapist can advise on safe setup.

How soon can I drive?

Driving usually waits until you can get in and out safely, control the leg without pain medicines that impair alertness, and have clinician clearance.