Hip Dislocation Fractures in Elderly Patients: Post-Surgery Concerns

Femoral dislocation fracture?

Hello Doctor: My grandmother is nearly 90 years old and fell a few days ago.
She was taken to the emergency department at Pingji Hospital, where it was found that her thigh bone was dislocated.
After evaluation by the physician, her health reports were normal, so she underwent surgery with spinal anesthesia to insert a steel pin.
I would like to ask: 1.
After the surgery, my grandmother needed a blood transfusion due to low hemoglobin levels.
What could be the reason for this? 2.
The day after the surgery, my grandmother experienced gastrointestinal discomfort as a side effect of the medication, making it difficult for her to eat or drink.
Should we force her to eat and drink? 3.
Because she was drinking less, her urine output was low.
The nurse mentioned that lying down resulted in very little urine, so they asked my grandmother to get out of bed to use a bedside commode.
However, the process of getting out of bed was not only exhausting for the person assisting her, but it also caused my grandmother pain, and her legs could not be stabilized.
Although it was painful, she was able to urinate a bit more.
The nurse said that the pain would lessen over time.
Is it really safe for her bones during the process of getting out of bed? I understand that the wound will hurt, but I am concerned about the condition of the bones inside...

Hsuan, 10~19 year old female. Ask Date: 2016/09/25

Dr. Hong Ximing reply Orthopedics

The attending physician will assess the patient's condition before and after the surgery and provide appropriate management.
Any questions should be discussed with the attending physician, as other doctors may not be familiar with the patient's condition and may not be able to provide clear answers.

Reply Date: 2016/09/25

More Info

Understanding hip dislocation fractures in elderly patients, particularly in the context of post-surgery concerns, is crucial for both caregivers and healthcare providers. Your grandmother's situation, given her age and the nature of her injury, raises several important considerations regarding her recovery and care.

1. Need for Blood Transfusion: The requirement for a blood transfusion post-surgery is often due to a drop in hemoglobin levels, which can occur for several reasons. In elderly patients, especially those undergoing surgery, blood loss during the procedure can lead to anemia. Additionally, pre-existing conditions such as chronic diseases or nutritional deficiencies can exacerbate this situation. The surgical procedure itself, even if minimally invasive, can cause some degree of bleeding. Monitoring hemoglobin levels post-surgery is essential, and if they fall below a certain threshold, a transfusion may be necessary to ensure adequate oxygen delivery to tissues, which is vital for healing.

2. Postoperative Nausea and Appetite: It is not uncommon for patients, especially older adults, to experience nausea and reduced appetite following surgery due to anesthesia and pain medications. While it is important for your grandmother to stay hydrated and nourished, forcing her to eat or drink when she feels nauseous may not be advisable. Instead, offering small, frequent meals and clear fluids can help. If her nausea persists, it would be prudent to discuss this with her healthcare provider, as they may be able to adjust her medications or provide anti-nausea treatments.

3. Concerns About Mobility and Pain: The process of getting your grandmother out of bed and to the bedside commode can indeed be challenging, both for her and the caregivers. Pain during movement is expected after surgery, especially with hip fractures, but it is crucial to differentiate between normal postoperative pain and pain that may indicate a complication. The surgical team typically provides guidelines on how much weight can be placed on the affected leg and when it is safe to begin moving. If your grandmother is experiencing significant pain or if there are concerns about her mobility, it is essential to communicate these issues to her healthcare team. They can assess her condition and determine if further imaging or intervention is needed to ensure that the surgical repair is intact.

In summary, your grandmother's recovery will require careful monitoring and communication with her healthcare providers. It is essential to address her nutritional needs, manage her pain effectively, and ensure safe mobility to promote healing. The surgical team will be best equipped to provide guidance on her specific situation, including any necessary adjustments to her care plan. Regular follow-ups and open communication about her symptoms will be key to a successful recovery.

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