Hip fracture surgery: types of operation, risks and recovery

A broken hip is a serious injury, most often from a fall in older people or from a high-energy impact in younger ones. Surgery lets people get out of bed within a day, which reduces complications from lying still such as chest infections, pressure sores and clots. For that reason, the NHS describes operating on the same day or the day after arrival.

Surgery is occasionally not advised when someone is too unwell for an anaesthetic, in which case pain relief and mobilising as far as possible are the focus. That decision is made with the person and their family, and a senior team explains the options.

The NHS lists three kinds. Where the bone can be saved, the pieces are fixed back into place with screws, nails, rods or plates. If the blood supply to the ball is likely to have been lost, part of the joint is replaced with an artificial one (hemiarthroplasty). Alternatively all of the damaged joint, ball and socket, may be replaced.

The choice depends on the location and pattern of the break, your age, how active you were before and your general health. Ask the team why that operation was chosen and what movements to avoid afterwards.

There is little time to prepare, so the focus is on pain relief, fluids and tests. Bring or ask someone to bring a list of medicines, any allergies, glasses, hearing aids and dentures. Tell staff about blood thinners promptly, because they affect timing.

Family and carers can help by telling the team about how the person manages at home, any memory problems and who is available to help afterwards.

The NHS page notes the seriousness of the injury and that some people never fully regain the strength and movement they had before, and may need mobility aids or help from carers. Surgery carries general risks such as chest infection, blood clots, wound infection, confusion after the operation (delirium) and, with replacement, dislocation. The pages retrieved did not give statistics, so none are quoted here.

Physiotherapists help you stand and move from the day after surgery. Hospital stay averages one to four weeks, per the NHS, and rehabilitation continues at home, in a community unit or both. NHS Inform advises regular pain relief for around six weeks, a gradual return to activities and work between six and twelve weeks, and higher-impact activity from about twelve weeks.

Walking practice starts on even surfaces for short periods, with a suggestion to aim for five minutes of confident walking and build time every few days.

• Persistent pain despite your medicines.

• Wound leakage, itching or separation.

• Calf or thigh pain, or red or darkened skin: possible clot, contact your GP urgently.

• Sudden breathlessness or chest pain: call 999.

• A fall, or new inability to put weight on the leg: seek urgent assessment.

• Which operation have I had and why?

• Are there movements or positions I must avoid?

• What rehabilitation will I get and where?

• What support will be needed at home, and how can falls be prevented?

• Should I have a bone health review, since a hip fracture can signal osteoporosis?

Most hip fractures are treated through NHS emergency pathways because they need urgent surgery and often specialist care of older people. Private hospitals can operate in some circumstances, but the rehabilitation and any medical complications still need sound hospital support. If considering private care, ask what happens if you become unwell and whether rehabilitation is included.