Surgical treatment, rehab, and self-care for hip fracture healing
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Hip fracture surgery is a common procedure for individuals, particularly the elderly, who have suffered a broken hip. The recovery process varies from person to person, but there are some general steps and key components that are essential for a successful recovery.
Immediate Recovery (Day 1-2 post-surgery)
Immediately after surgery, patients are encouraged to get out of bed and begin physical therapy within 24 hours. Early movement helps prevent medical complications such as blood clots, pneumonia, and bed sores, and reduces risks of disorientation and physical deconditioning. Pain levels are assessed frequently, and pain relief, often including opioids or other analgesics, is administered as needed. Antibiotics may be given for about 24 hours post-op to prevent infection, and blood thinners help prevent clots.
First Week
During the first week, physical therapists guide patients in safe mobility techniques, assisting them with walking, sitting up, and transferring. Occupational therapists may assist with daily living activities such as bathing and dressing, adapting to restrictions on weight-bearing or movement dictated by the surgeon. Patients continue to receive pain management and monitoring of wound healing, bowel function (addressing side effects of pain meds), and vital signs.
Weeks 2 to 6
In the following weeks, patients typically continue regular physical therapy focused on strengthening and increasing the range of motion around the hip joint. Weight-bearing recommendations vary depending on the fracture type and repair method but are closely monitored and adjusted by therapists and surgeons. Many patients begin to regain independence and progressively return to normal activities without restrictions within about 6 to 12 weeks, though some, especially older adults, may require more time.
Months 2 to 6
More intensive rehabilitation continues, with patients often able to resume low-impact activities, walking unaided, and climbing stairs. Physical therapy emphasizes muscle strengthening and joint flexibility. Full recovery, defined as the return to pre-injury function and pain-free movement, may take anywhere from 3 to 6 months depending on overall health, age, surgical outcomes, and rehabilitation success.
Key Components
- Physical therapy: Starts early (within 24 hours), with gradual progression from assisted movement to independent walking and strengthening exercises over several months. Therapists also teach safe techniques for daily activities to avoid re-injury.
- Pain management: Includes scheduled pain medications post-op, often opioids initially combined with non-opioid analgesics, with adjustments as healing progresses. Attention is given to side effects such as constipation, often managed with laxatives.
- Rehabilitation: Involves multidisciplinary care with surgeons, internists (for medical issues), physical and occupational therapists. Focus is on restoring independence, muscle strength, joint mobility, and preventing complications.
Caring for Yourself at Home
To care for their wound at home, a person should keep the wound area dry and clean, follow the instructions from a healthcare professional, and avoid removing a wound dressing for 7-10 days. Proper nutrition during recovery is important, especially in older people, to improve the outcome of surgery. To reduce swelling, a person can slightly elevate their leg and apply an ice pack.
Preventing Complications
Individuals recovering from hip surgery should take all medications as their doctor prescribes, which may include opioid pain medication, non-opioid pain medication, stool softeners, blood thinning medication, anti-nausea medication. To avoid strenuous activity and reduce the risk of injury after surgery, a person should avoid bending, face the affected leg forward and keep it in front while they sit or stand, use a high barstool in the kitchen, and apply heat before exercise.
When to Seek Medical Attention
People should contact a doctor if they experience symptoms of an infection or a blood clot, such as fever, drainage from the wound, chills, tenderness, redness, or swelling of the wound, worsening pain during rest and activity, redness or tenderness above or below the knee, pain in the calf or leg that is unrelated to the incision, severe swelling in the calf, ankle, thigh, or foot that does not respond to elevation, sudden chest pain, coughing with localized chest pain, shortness of breath.
Avoiding Alcohol and Maintaining a Healthy Weight
Avoid alcohol during recovery, and try to maintain a moderate weight to avoid putting stress on the healing joint. More than 300,000 people in the United States experience a hip fracture each year, and the recovery program provided to individuals varies depending on their level of mobility and fitness.
In conclusion, most patients undergoing hip fracture surgery can expect to regain significant function within 3 to 6 months, though the initial phase requires careful pain control, prevention of complications, and consistent physical therapy starting immediately after surgery. Older adults may experience longer recovery times, but early mobilization remains crucial for better long-term outcomes. Surgical intervention can help reduce the mortality rate associated with hip fractures.
- Physical therapy is an essential component of the recovery process for individuals who have undergone hip fracture surgery.
- The immediate focus of physical therapy is to prevent medical complications such as blood clots, pneumonia, and bed sores.
- Fracture patients are encouraged to start physical therapy within 24 hours after surgery, with frequent pain assessments and pain relief administration.
- Antibiotics and blood thinners are often administered in the first 24 hours post-op to prevent infection and clots respectively.
- During the first week, physical therapists guide patients in safe mobility techniques while occupational therapists help with daily living activities.
- In weeks 2 to 6, physical therapy focuses on strengthening and increasing the range of motion around the hip joint.
- Chronic kidney disease, respiratory conditions, and other medical-conditions might affect the recovery process due to the need for adjustments in weight-bearing recommendations and rehabilitation plans.
- Eye-health and hearing should also be considered during the recovery period, as some medications used for pain management may have side effects on vision and hearing.
- Mental-health, mens-health, and women's-health are equally important during the recovery process, and addressing these issues can contribute to overall well-being.
- Skin-care is crucial during the recovery phase, as proper wound care and hygiene can help prevent infections and excessive scarring.
- Therapies and treatments for chronic diseases, such as weight-management programs for chronic kidney disease, can enhance the recovery outcome for certain individuals.
- Nutrition plays a significant role in the recovery process, especially for older people, to improve the outcome of surgery and promote overall health and wellness.
- The use of CBD oil for managing pain during the recovery process is not extensively studied yet, so it should be discussed with a healthcare professional before considering as a treatment option.
