Houston Methodist. Leading Medicine

Hip FAQ

Question:

Dad fell over the weekend and was hospitalized with a broken hip. It's been 48-hours and he still hasn't had surgery. They say he has to have more tests done before they can operate. Is this normal?

Answer:

Preoperative testing is not uncommon before surgery -- especially for older adults who are at risk for complications from surgery. The surgeon wants to do everything possible to reduce those risks and assure the best results possible. Some of the more typical tests are to assess heart health and the risk of cardiac complications. Anyone with a history of unstable coronary syndrome, heart failure, valve disease, or problems with heart rhythm (arrhythmia/dysrythmia) will likely have a preoperative cardiac evaluation. The presence of any infection such as urinary tract infection or upper respiratory infection (e.g., pneumonia) will also increase the risk of serious complications after surgery. And by serious, we mean that studies show the death rate is higher for patients with these kinds of health concerns. Malnutrition is another problem that can affect the results of surgery. Nutrition experts have found that older adults who break a bone due to osteoporosis (brittle bones) often have low bone density because of a poor diet. On the other hand, there is some evidence that delays in surgery needed to repair a hip fracture can also represent a risk factor of its own. Even patients who are health going into the surgery are at an increased risk of infection and death when there's a 24-hour delay. And delays also increase the risk of pressure ulcers (bed sores) in anyone who is malnourished. As a family member and advocate for your father, you can ask for an explanation for the delays and express your concerns. There may be other reasons why the operation has not taken place yet. Hospitals deal with limited staffing over the weekends, limited numbers of operating suites, and prioritizing surgical cases based on severity and availability of surgeons. All of these factors could have a role in your father's current situation. Philipp N. Streubel, MD, et al. Fragility Fractures: Preoperative, Perioperative and Postoperative Management. In Current Orthopedic Practice. September/October 2009. Vol. 20. No. 5. Pp. 482-489.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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