Is it better to replace or repair a hip fracture?

Our orthopedic surgeon tells me total hip replacement is better than fixing or repairing many hip fractures. How much “better” is better? And what’s better about it?

Many studies show that total hip replacement (THR) for some types of hip fracture gives superior results when compared to internal fixation. Any time screws, pins, or metal plates are used to repair a hip fracture, it’s called open reduction internal fixation (ORIF).

An ongoing study from Sweden compared 53 patients with THR to 49 patients with ORIF. Patients in both groups lived alone and could walk before their hip fractures. All were in good mental and physical health.

At the end of two years, the THR group had much better outcomes compared to the ORIF group. The same results were present at the end of four years. For example 42 percent of the ORIF group had hip complications requiring a second operation. This was compared to four percent of the THR group.

By the time the ORIF group was converted to a total hip, they had lost function, walking ability, and were having more pain than the THR group. Quality of life was also significantly reduced after so much pain, loss of function, and multiple operations.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

My husband broke his hip. The surgeon explained that there are two options: repair or replace the hip. Which is best?

My husband is quite a bit older than me and needs surgery to repair a displaced, broken hip. The surgeon has explained the two options: repair or hip replacement. It does make sense to try and repair it first. If it doesn’t work, then we can still go with the hip replacement. Is there a downside to this approach?

The treatment of some types of hip fractures remains a hotly debated topic among surgeons. Displaced femoral neck fractures can be especially complicated. Displaced refers to the fact that the broken bones have shifted away from each other. They no longer line up so good healing is not likely without surgery to repair or replace the bones.

Studies show that all in all, it makes more sense and costs less for the older adult to have a hip replacement. Reduction and internal fixation (the repair option) has a higher rate of complications. If the bone fails to heal, then a second surgery (hip replacement) is needed.

A total hip replacement (THR) after failed fixation does not give the same results as if the THR was done in the first place. Quality of life is less and cost is more when two surgeries are done instead of just one. There is also a chance that function will be further reduced by the second operation.

The repair option is advised if the patient is a good candidate for this management approach. This is usually the young, active adult who is in good health both mentally and physically. With good bone quality, there is an excellent chance for successful healing with no complications.

For the older adult who has decreased bone density, diminished mental capacity, or who had poor function before the fracture, THR is advised.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.