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Hip Fracture Surgery

Written by Dr Chien-Wen Liew

When there has been a fall, and a broken hip, many considerations are made, not just for the hip.

This guide is to help you learn more about the various types of hip fractures. They all call for specialised, different treatments.

Hip fractures are broadly divided into the ones that occur within the blood supply sheath, and ones that are outside of this. The capsule supplies the blood to the ball (femoral head). Generally, if a fracture occurs within the blood supply sheath, then the hip requires a replacement. For this, a total hip replacement performed via the direct anterior approach is highly suitable. When the fracture occurs outside the sheath, then the fracture is normally fixed.

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Intra-Capsular Fracture

Fractures that occur within the blood supply to the femoral head as shown above, usually mean that the blood supply to the ball is lost. The quickest way to resolve this and get back on your feet is to have a Total Hip Replacement. The direct anterior approach is a minimally invasive way to achieve this.

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Intra Vs Extracapsular Fractures

When a fracture occurs outside the blood supply zone, then this is classed as an extra-capsular fracture. This type of fracture can often be fixed, with a device that sits within the bone. Because the blood supply to the ball is preserved, the fracture will often heal well.


Can you Manage
A Hip fracture
Non operatively


Non Operative Management

Whilst the mainstay of treatment is an operation, some patients receive non operative management

For some patients, the risk of surgery and the benefits don’t match. Hip fractures can heal without surgery, however the downside is that usually the requirement is to rest in bed. Statistics and research show that patients who remain in bed whilst they have a hip fracture often end up with a very poor outcome. When a poor outcome is expected, then it can be more suitable to avoid surgery. This decision is not an easy one, and requires a lot of thought.

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