Hip treatment
Hip fracture fixation repairs a broken hip with metal implants instead of replacing the joint — screws, a plate and sliding screw, or a rod down the centre of the bone. Which one you need is decided almost entirely by where the bone has broken, because location determines whether the blood supply survived. What every option shares is the goal: a hip stable enough to stand on within a day, since it is lying still, not the fracture itself, that does most of the damage to an older person.
A broken hip is really three different injuries wearing one name, separated by a few centimetres of bone. Fractures through the narrow top of the thigh bone — the short section joining the ball to the shaft — sit inside the joint capsule, where the blood supply to the ball runs — displace one badly and that supply may be lost, which is why replacing the ball is often more dependable than fixing it. Breaks just below that narrow section and further down the shaft have a generous blood supply and knit reliably once held securely, so those are fixed: a plate with a sliding screw, or a rod passed down the hollow of the bone and locked top and bottom. Both allow weight through the leg almost immediately, which is the entire point.
Of every 100 broken hips — where the break sits, and what that means
Proportions describe broad patterns in older adults — your own fracture, bone quality and health decide the operation and the timeline.
Families usually arrive with one question above all the others. Tap yours — the straight answer is one scroll away.
Almost always, and the reason is worth understanding. A broken hip that is not fixed does not simply hurt — it makes every movement painful, so the person stops moving, and that is where the damage compounds: chest infections, pressure sores, clots, muscle loss and confusion arrive within days of being confined to bed. Fixation is therefore the most effective pain relief available, because a stable hip can be moved, sat up, and stood on.
There are rare situations where surgery is genuinely not the right path — someone very unwell, or a fracture that is stable and barely displaced in a person who is already comfortable. Those decisions are made openly with the family, and non-operative care is then organised properly rather than by default. But for the great majority, the operation is the route back to sitting in a chair by the next morning.
The honest answer is that a broken hip has already introduced the risk; the operation is how we reduce it. Anaesthesia and surgery in a frail patient carry real dangers — heart and chest complications, clots, infection, bleeding, and confusion in the days afterwards, which is common, distressing to witness and usually temporary. Those risks rise with existing heart, lung and kidney disease, and they are weighed individually rather than assumed.
What they are weighed against is the alternative, and that comparison is rarely close. Beyond the general risks, fixation carries its own: the implant can cut out or loosen when bone is very soft, the fracture may not knit, and a break through that narrow section can lose its blood supply later even after a technically sound repair — any of which may lead to further surgery. Preparation is where risk is genuinely reduced: correcting fluids, blood counts and salts, managing blood-thinning treatment, and getting to theatre promptly rather than after days of waiting.
Most people do, and the strongest predictor is how they were walking the week before the fall. Someone independent beforehand has a good chance of returning to a frame or a stick and then to independence; someone already frail usually regains less. Standing begins the day of surgery or the day after, the bone knits over six to twelve weeks, and rehabilitation continues for months. Where are you in this?
Do not let anyone walk on a hip that may be broken, and do not offer food or drink until they have been seen. An empty stomach keeps surgery possible today rather than tomorrow. Bring the medication list, including any blood-thinning treatment, and a note of how they were managing at home before the fall.
Ask two questions: which operation, and what weight will be allowed afterwards. Those two answers shape everything that follows, from the ward to the discharge plan. Start arranging help at home now rather than at discharge — the first fortnight back is where most families are caught unprepared.
Little and often beats one long effort, and the bone review matters as much as the physiotherapy. Progress can be slow and is still progress. Report new pain on weight-bearing, a leg that turns outward, fever or wound discharge without waiting for the scheduled appointment.
Fractures below that narrow section knit reliably, because the blood supply there is generous; most are solid within six to twelve weeks. Fractures through the narrow section itself are less predictable, since the vessels feeding the ball run across the break — a proportion fail to unite, and some lose their blood supply months later even when the repair looked perfect. That is precisely why a badly displaced fracture through that narrow section in an older person is usually replaced rather than fixed in the first place.
Where healing does fail, the usual answer is conversion to a hip replacement, which is a bigger undertaking than a primary replacement but a well-trodden one. The other recurrence worth naming is a second fracture: breaking one hip roughly doubles the risk of breaking the other, and that risk is reduced by treating the underlying osteoporosis, correcting vitamin and calcium status, improving balance and strength, and dealing with the rugs, cords, lighting and bathroom hazards that caused the first fall.
Our specialist decides this from the X-ray and the person, not from preference. These are the factors that push towards fixing the bone rather than replacing the joint — check any that apply:
Those factors favour fixing the bone and keeping the joint. Fixation preserves your own hip, which matters most in younger patients and in breaks with a dependable blood supply. The X-ray settles it, and our specialist will explain which implant suits the pattern of your fracture and what weight you can take afterwards.
Where few or none of those apply, replacing the ball is often the more reliable route. A displaced fracture through that narrow section in an older adult risks losing its blood supply, and a replacement avoids a second operation later. Either way this is decided within hours, not days — call us and bring the X-ray if one has been taken.
And remember: this decision belongs to the X-ray and the person — a checklist can only tell you which way it usually leans.
Tap each card to reveal the answer:
Surgery that repairs a broken hip using metal implants rather than replacing the joint. Depending on where the bone has broken, that may mean screws holding the top of the thigh bone together, a plate with a sliding screw, or a rod passed down the inside of the bone and locked at both ends. The aim is the same in every case: a break stable enough to stand on, so that recovery can begin within a day.
Chiefly by where the break sits and what it has done to the blood supply. A fracture through the narrow top of the thigh bone, just under the ball, can interrupt the blood reaching it, so when it is displaced, replacing the ball is usually more reliable than fixing it. Breaks further down have a better blood supply and heal well once held securely, so those are fixed. Age, previous mobility and any existing arthritis all factor into the final choice.
Generally within twenty-four to forty-eight hours, once you are medically fit. Earlier surgery is associated with less pain, fewer chest and skin complications and a better chance of walking again, because it is lying still that causes most of the harm. Occasional delays are unavoidable when blood-thinning treatment or another medical problem needs managing first, and that wait is used productively rather than passively.
In most cases yes, and usually straight away. Modern implants are designed to share load so that standing and walking with a frame can begin the day of surgery or the day after. Where the break was in many pieces or the bone is very soft, our specialist may ask for partial weight only for a period of weeks. You will be told exactly which applies to you before you get up.
Infection, clots, bleeding and the general risks that come with surgery in older patients, including confusion in the days afterwards. Specific to fixation: the bone may fail to knit, the implant can cut out or loosen if the bone is very soft, and a fracture through the narrow top of the thigh bone can lose its blood supply later even when the repair was sound. Any of those may lead to further surgery, sometimes a replacement.
Standing and walking begin almost immediately with support, and rehabilitation continues for months rather than weeks. Alongside that, the fracture itself is treated as a warning: bone density, vitamin status, balance, eyesight, footwear and home hazards are all reviewed, because someone who has broken one hip is at real risk of breaking the other. Preventing the second fracture is part of treating the first.
Related: hip fractures · total hip replacement · all hip surgery · physiotherapy
Same-day appointments are usually available. Call or book online — our team will take it from there.
