Patient education: Hip fracture in adults – Discharge instructions (The Basics)

What are discharge instructions? — Discharge instructions are information about how to take care of yourself after getting medical care for a health problem.

This article has information for people who have had a hip fracture. A separate article is available for people who have had a hip replacement.

What is a hip fracture? — A "fracture" is another word for a broken bone. A hip fracture is when a person breaks the top of the thigh bone (femur) near the hip joint (figure 1).

There are different types of hip fractures. The type of fracture depends on which part of the thigh bone breaks and how it breaks. When a bone breaks, it might crack, break all of the way through, or shatter.

Hip fractures are usually caused by falls. Hip fractures happen most often in older adults, especially those with osteoporosis. Osteoporosis is a disease that makes the bones weak.

How are hip fractures treated? — Most people with a hip fracture are treated with surgery. People usually have surgery within a few days of their injury. Doctors can use 2 main types of surgery to treat a hip fracture, depending on the type:

●In 1 type of surgery, the doctor uses screws, pins, rods, or plates to fix the fracture.

●The other type of surgery is a total or partial hip replacement. For this surgery, the doctor replaces either the whole hip joint or parts of it with artificial or "prosthetic" parts.

In some cases, hip fractures are not treated with surgery. Examples of people who might not need surgery include:

●People who have mild fractures and can still walk

●People who no longer walk and are not in a lot of pain

If a person does not have surgery, their fracture might heal on its own.

How long it takes to recover, and what you need to do, depends on whether you had surgery and what type of surgery you had. Some people can go home after a hip fracture. Other people might spend 1 to 3 nights in the hospital. Or they might need to go to a "rehabilitation" facility, also called "rehab." At rehab or after you go home, you might also work with a physical therapist (exercise expert). This can help you get stronger and improve your movement and balance. Most people will regain their full strength within 6 months after their fracture.

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

If you had surgery:

●For the first 24 hours after surgery:

•Do not drive or operate heavy or dangerous machinery.

•Do not make any important decisions or sign any important papers.

•Do not drink alcohol of any kind.

●Take care of your incision– You might have stitches, skin staples, surgical glue, or a special skin tape on your incision.

•Keep your incision dry and covered with a bandage for the first 1 to 2 days after surgery. Your doctor or nurse will tell you exactly how long to keep your incision dry.

•Once you no longer need to keep your incision dry, gently wash it with soap and water whenever you take a shower. Do not put your incision underwater, such as in a bath, pool, or lake. This can slow down healing and raise your chance of getting an infection.

•After you wash your incision, pat it dry. Your doctor or nurse will tell you if you need to put an antibiotic ointment on the incision. They will also tell you if you need to cover your incision with a bandage or gauze.

•Always wash your hands before and after you touch your incision or bandage.

After a hip fracture, you should:

●Wear special boots or stockings, if your doctor told you to do this. These can help prevent blood clots in your legs.

●Take all of your medicines, including any medicines to prevent blood clots. Your doctor might prescribe a medicine to help with osteoporosis. This might help prevent another fracture.

●Use a stool softener to help prevent constipation, if needed. This is a common problem if you take opioid pain medicines. Follow all instructions for taking your pain medicines.

●Work with a physical therapist. They can teach you exercises to make the muscles around your hip stronger. They will also work with you on bending, walking, and climbing stairs so that you can move normally. This is very important to help you recover as quickly as possible and get back to your usual daily activities. Moving your leg regularly also helps lower the risk of blood clots.

●Increase your activity slowly – Most people can stand and walk (with help) shortly after a hip fracture repair.

•Follow all instructions for using a walker, crutches, or cane. Make sure that you know how much weight you can put on the leg with the broken hip. This can range from no weight-bearing to full weight-bearing.

•Start with short walks around your home, and walk a little more each day.

•Avoid heavy lifting, driving, sports, and swimming for at least a week or 2. (Your doctor, nurse, or physical therapist will tell you exactly how long to avoid these or other activities.) Over time, slowly increase your level of activity as you get stronger.

●Eat a healthy diet that includes plenty of calcium, vitamin D, and protein (figure 2).

●Stop smoking, if you smoke. Broken bones take longer to heal if you smoke.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. Go to these appointments.

If you have stitches or staples, you will need to have them taken out. Your doctor will usually want to do this in 1 to 2 weeks. Some stitches absorb on their own and do not need to be removed. If the doctor used skin glue or tape, it will fall off on its own. Do not pick at it or try to remove it yourself.

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You feel short of breath or have trouble breathing.

●You have sharp or severe chest pain when you breathe.

●You are coughing up blood.

Call the doctor or nurse for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have worsening redness, drainage, or swelling around the cuts from your surgery.

●You have more pain or swelling in your hip or leg.

●Your toes turn pale, blue, or gray.

●You have less feeling or movement in your foot or toes.

More on this topic

Patient education: Hip fracture (The Basics)
Patient education: Hip replacement (The Basics)
Patient education: Calcium and vitamin D for bone health (The Basics)
Patient education: How to use crutches (The Basics)

Patient education: Total hip replacement (Beyond the Basics)
Patient education: Calcium and vitamin D for bone health (Beyond the Basics)