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My 85-year old father fell from his roof while cleaning out his gutters. The surgery for his hip fracture went well but the surgeon says he's not out of the woods yet. We're not sure what that means exactly. Can you enlighten us?

Hip fractures in older adults can be complex and challenging to treat and manage well. Fractures from a high-energy injury such as your father's fall from a height can be accompanied by other injuries as well. Sometimes it takes some time for other problems to surface.

Any hip fracture can be the catalyst that causes loss of independence. Serious complications such as pneumonia, infection, and blood clots can compromise return to health. Your father will be under close surveillance while in the hospital until his condition is stable.

Most older adults have some form of osteoporosis. The bone loses mass and density and becomes more prone to fracture. This makes it difficult to stabilize the fracture with plates, screws, or pins inserted into or even through the bone.

There is some danger that the fractured ends of the bone may collapse toward or into each other. There is always a risk of nonunion. Nonunion means the bone doesn't heal or healing is interrupted and delayed a long time. Sometimes scar tissue forms but without good bone repair.

You'll need to speak to the surgeon to find out more specifically what the concerns are for your father. He may have just been referring to the general process of recovery and rehab. Or there may be something unusual about the type of fracture that puts your father at increased risk of delayed healing.

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