Osteosynthesis of hip fracture

The acetabulum (cup) is a regular smooth hollow structure in the hip joint in which the head of the thigh bone (femur) is located and moves in several directions. Any change in the cup caused by disease or injury has consequences in the mobility of the leg.

Acetabulum fractures are less common than femoral head fractures and are mostly caused by some type of high-energy event, eg. during a car crash. Many times patients will have additional injuries that require immediate treatment. In fewer cases, a low-energy incident, such as a fall from standing, can cause an acetabulum fracture in an older person who has weaker bones.

Treatment of acetabulum fractures often involves surgery to restore normal hip anatomy and stabilize it. Depending on the type of injury and the condition of the patient, hip joint repair can be performed by implanting an artificial hip or by osteosynthesis – joining and repositioning the parts to their original place.

When is osteosynthesis of a fracture of the hip joint done?

Nonsurgical treatment may be recommended for stable fractures in which the bones of the cup have not moved out of place, especially in patients who are at higher risk of surgical complications, such as patients with severe osteoporosis, heart disease, or other medical problems who may not be able to tolerate surgery.

Non-surgical treatment may include:

• walking aids: to reduce the weight load on the hip joint, the doctor may recommend the use of crutches or a walker for up to three months or until the bones are completely healed;
• positioning aids: if the doctor is concerned about instability of the joint when the femoral head slides inside or pops out of the acetabulum, it is possible to limit the movements of the hip, that is, limit how much it is allowed to bend; leg positioning devices or items, such as an abduction pillow or knee immobilizer, can help keep these restrictions in place;
• Medicines: the doctor may prescribe medicines to relieve pain, as well as an anticoagulant (blood thinner) to reduce the risk of blood clots in the leg veins.

However, most acetabulum fractures are treated with surgery. Because acetabular fractures damage the cartilage surface of the bone, an important goal of surgery is to restore the smooth, gliding surface of the hip socket.

How is the osteosynthesis of hip fracture?

During surgery, the orthopedist will reconstruct the normal anatomy of the hip joint, aligning and repairing bone fragments to restore the surface of the acetabulum. Most often, these fractures are not treated immediately, but, postponing the operation, doctors try to make sure that the general condition of the patient is stable and well enough for the surgical procedure. During this time, skeletal traction is often used to prevent further injury or damage to the acetabulum while relieving the patient’s pain. Often, skeletal traction proves to be sufficient to reposition the fragments, thus avoiding surgical intervention. During the surgery itself, the displaced bone fragments are first repositioned to their normal position, and then metal plates and screws are placed on the outer surfaces to secure the fragments to stay together until they grow back together.

Depending on the location of the fracture, the doctor makes an incision along the front, side, or back of the hip. Sometimes a combination of these approaches or some alternative approach is used.

Recovery after osteosynthesis of hip fracture

Medicines are often prescribed to relieve pain after surgery. Most patients need crutches or a walker during recovery. Full hip support usually takes 3-4 months. It is important to follow the doctor’s specific instructions, because walking on the injured leg before it heals or participating in physical activities too soon can cause the surgically repaired fracture to move again. Due to the complicated nature of many acetabulum fractures, some patients are unable to return to their pre-injury activity level.

For all additional information and appointments, call the BioCell Hospital contact center at 011 66 88 000 or 060 66 88 000, and you can also contact us via the contact form by clicking on the CONTACT link