My husband broke his hip in a skiing accident this morning. He's in surgery now. They didn't know what kind of operation he would have -- he could even end up with a total hip replacement. How is this decided, anyway?
Age of the patient, condition of the bone, type of fracture, and mental capacity are just a few factors the surgeon takes into consideration. Adults less than 60 years of age who need surgery for a broken hip usually have a pin and/or metal plate to hold the bones together. This is called internal fixation.
If there is severe arthritic disease, bone cancer, or severe osteoporosis, then a total hip replacement may be needed. Depending on the fracture type, the patient may end up with a hemiarthroplasty. The hemiarthroplasty replaces the head and neck of the femur (thighbone) but leave the patient's own acetabulum (socket) in place.
Total hip replacement (THR) is more common in older adults. There are benefits and disadvantages for each type of surgery. Hemiarthroplasty only replaces the broken side but can result in bone erosion and a painful hip. This is more likely to happen in a younger, active adult.
THR is subject to hip dislocations. There's also a limited life to a THR. In younger adults, a THR may have to be replaced again 10 to 15 years later. This can mean more bone loss, more scarring, and decreased function for some patients.
After the operation and while your husband is still in recovery, the surgeon will come out to the waiting area and tell you what was done. Use that opportunity to ask any questions you may have about what was done and why.
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