Houston Methodist. Leading Medicine

Hip FAQ

Question:

I'm writing to you from a hospital bed after tripping over a shoe lace and breaking my hip (a femoral neck fracture). I don't have much time before the nurses come in and scold me for being on the computer. Please tell me the pros and cons of having the bone pinned together versus having the joint replaced.

Answer:

You didn't mention your age or bone status, two important points in making these choices. Older patients (65 years old and older) with poor bone density may not be able to grow enough new bone to heal a fracture that's pinned. The hip replacement may be the best option.

Is the fracture stable (fracture line hasn't moved), separated (bone has drifted apart) or impacted (one side of the fracture is pushed into the other side)? A stable fracture that hasn't moved or shifted is often treated by internal fixation. This means screws are used to hold the bone together until it heals.

If the fracture can't be pinned together or if there are serious arthritic changes in and around the bone and joint, then a joint replacement may be needed. According to the results of a recent study, older adults have better results with a total hip replacement.

William L. Healy, MD, and Richar Iorio, MD. Total Hip Arthroplasty. In Clinical Orthopaedics and Related Research. December 2004. Vol. 429. Pp. 43-48.

*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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