Post-Operative Care and Rehabilitation After Hip Fracture Surgery

Postoperative hip joint care

Hello, I had a right femoral neck fracture on July 4th and underwent open reduction and internal fixation surgery.
Three days later, under the guidance of my doctor and nurses, I started practicing walking with crutches.
However, when I was discharged, they only mentioned when to return for a follow-up and did not provide further information.
After returning home, I researched rehabilitation and the movements I could perform, but I only found information related to hip replacement.
Therefore, I would like to ask the following questions:
1.
Are the movements and rehabilitation for my condition similar to those for a general femur fracture, or do I need to be cautious about the 90-degree rule like with hip replacement?
2.
After a few months of recovery, will I be able to squat, sit, and perform various normal activities like before?
Thank you for your response.

Chen Jiabao, 40~49 year old female. Ask Date: 2020/07/23

Dr. Chen Yongxue reply Orthopedics

Hello, if it is a femoral neck fracture, there are two treatment options: hemiarthroplasty or open reduction and internal fixation.
According to your letter, the latter was performed.
In that case, future hip joint mobility should not be limited; the only concern is whether you can bear weight before the fracture heals.
As for whether your fracture can bear weight, please follow the advice of your attending physician.
Thank you.

Reply Date: 2020/07/23

More Info

Post-operative care and rehabilitation after hip fracture surgery are crucial for a successful recovery and to minimize the risk of complications. Given your recent surgery for a right femoral neck fracture and the subsequent open reduction and internal fixation (ORIF), it is essential to follow a structured rehabilitation program tailored to your specific needs.

1. Rehabilitation Protocol: After hip fracture surgery, the rehabilitation process typically involves a combination of physical therapy and gradual return to normal activities. While the rehabilitation for a hip fracture shares some similarities with that of hip replacement surgery, there are distinct differences, particularly regarding movement restrictions.
- Movement Restrictions: After hip fracture surgery, you should be cautious about certain movements, especially those that involve bending your hip beyond 90 degrees, as this can place undue stress on the surgical site. This is particularly important in the early stages of recovery. Unlike hip replacement patients, who often have more stringent restrictions, your focus should be on protecting the surgical site while gradually increasing mobility.

- Physical Therapy: Engaging in physical therapy is highly recommended. A physical therapist can guide you through exercises that strengthen the muscles around the hip, improve balance, and enhance mobility. Early exercises may include ankle pumps, leg slides, and gentle hip flexion and extension, progressing to more weight-bearing activities as tolerated.

2. Timeline for Recovery: The timeline for returning to normal activities varies based on individual healing rates and adherence to rehabilitation protocols. Generally, you can expect to regain most of your mobility within three to six months post-surgery. However, full recovery, including the ability to squat or sit cross-legged, may take longer, often up to a year or more, depending on factors such as age, overall health, and the extent of the injury.

- Gradual Progression: Initially, you may be able to perform basic activities such as walking with crutches or a walker. As your strength and confidence improve, you can gradually transition to walking without assistance. It is essential to listen to your body and avoid pushing through pain, as this can lead to setbacks.

3. Monitoring Symptoms: Pay attention to any unusual symptoms during your recovery, such as increased pain, swelling, or changes in mobility. These could indicate complications such as infection or hardware failure. Regular follow-up appointments with your orthopedic surgeon are crucial to monitor your healing progress and adjust your rehabilitation plan as needed.

4. Long-term Considerations: After a hip fracture, some individuals may experience long-term changes in their mobility or strength. It is essential to maintain a regular exercise routine that includes strength training, flexibility exercises, and balance training to support your recovery and prevent future falls.

In summary, while your rehabilitation after hip fracture surgery shares some principles with hip replacement recovery, it is essential to follow specific guidelines tailored to your situation. Engage in physical therapy, adhere to movement restrictions, and monitor your recovery closely. With time and proper care, you can expect to return to your normal activities, but patience and diligence in your rehabilitation efforts will be key to achieving the best possible outcome.

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