A hip fracture involves a break in the upper part of the femur, the thigh bone, near the hip joint. This injury often results from falls, especially in older adults, or high-impact trauma in younger individuals. Inpatient care is necessary due to the severe nature of these fractures, which require immediate medical intervention and extended recovery. Comprehensive medical attention manages pain, performs necessary procedures, and initiates rehabilitation.
Initial Hospital Admission and Assessment
Upon hospital arrival with a suspected hip fracture, patients are immediately directed to the emergency department for initial evaluation. Pain management is a priority, often involving intravenous medications like opioids for rapid relief. Medical professionals then conduct a thorough physical examination to assess the injury and the patient’s overall health status.
Diagnostic imaging, such as X-rays, confirms the fracture and determines its specific location and type. Sometimes, additional imaging like a CT scan or MRI may be used for more detailed views, especially if X-ray results are unclear or other injuries are suspected. This comprehensive assessment helps the medical team understand the fracture’s extent and plan the most appropriate course of treatment. Initial medical stabilization also occurs, addressing any other immediate health concerns.
Treatment Approaches During Inpatient Stay
For most hip fractures, surgical intervention is the standard treatment during the inpatient stay. The specific surgical procedure chosen depends on the fracture’s location, the patient’s age, and their overall health condition. Common surgical approaches include hip pinning, also known as internal fixation, where screws, rods, or plates are used to stabilize the broken bone fragments. This method is often preferred for less severe fractures or in younger patients.
For more complex fractures or in older adults, a partial hip replacement (hemiarthroplasty) or a total hip replacement (arthroplasty) may be performed. A partial hip replacement involves replacing only the femoral head, while a total hip replacement replaces both the femoral head and the hip socket. Non-surgical management is rarely used for hip fractures and is reserved for specific cases where surgery is not possible due to extreme patient fragility or other severe medical conditions.
Before surgery, patients undergo preparation, including medical clearance to ensure they are stable enough for the procedure. Following surgery, patients are closely monitored in a recovery room, where nurses and medical staff track vital signs, manage pain, and observe for any immediate post-operative complications. This immediate post-surgical care lays the groundwork for subsequent recovery.
Inpatient Recovery and Rehabilitation
Following initial treatment, the inpatient recovery phase focuses on pain management and early mobilization. Pain is monitored and managed using a combination of medications, which may include oral pain relievers, nerve blocks, or epidural analgesia, adjusted to the patient’s needs. Early mobilization is a primary goal, often beginning within a day or two after surgery, with assistance from hospital staff.
Physical therapists play a significant role during this period, guiding patients through gentle exercises to regain strength and flexibility. They assist with getting out of bed, sitting, and taking initial steps with the aid of walkers or crutches, ensuring proper weight-bearing instructions are followed. Occupational therapists also work with patients to practice daily activities like dressing and personal hygiene, helping them adapt to any temporary limitations. The medical team monitors for potential complications such as infections, deep vein thrombosis (blood clots), or pneumonia, often prescribing preventative measures like blood thinners and encouraging breathing exercises.
Preparing for Discharge
As the patient’s condition stabilizes and rehabilitation progresses, the healthcare team begins planning for discharge. This involves a comprehensive assessment of the patient’s mobility, strength, and ability to perform daily activities. Decisions regarding post-hospital care are made collaboratively, considering the patient’s home environment and support system.
Options for continued care may include returning home with home health services, transitioning to a dedicated rehabilitation facility for intensive therapy, or moving to a skilled nursing facility for ongoing medical and rehabilitative support. Before discharge, the patient and family receive detailed instructions on medication schedules, wound care, and follow-up appointments. This ensures a smooth transition and continued progress in their recovery journey.