Admission to Hospital
You will be assessed by one of the orthopaedic doctors in the Emergency Department (A&E) or on the ward. The doctor will discuss the operation and risk factors. If you are happy to proceed with surgery you will be asked to sign a consent form.
Depending on the time of day you are admitted to hospital, you will be seen by your consultant orthopaedic surgeon on the early morning or early evening ‘ward round’. The consultant will discuss the type of surgery you require and let you know when the operation is likely to be.
Hip fracture can be very painful, especially when the hip is moved. The nurses will offer you pain relief medicines (as tablets or liquid medicine) at least 4 times per day. You may also be offered a pain control (nerve block) injection which goes around the site of the fracture. This is very effective at controlling pain and means you will need less tablets/medicine. If you are in pain please tell your nurse.
Intravenous Fluids (a drip)
You will have a cannula (thin plastic tube) placed in a vein for a drip – this gives you fluid to prevent dehydration. You will also be encouraged to eat and drink normally, unless your surgery is expected to be in less than 6 hours.
When you need the toilet you will need to use a bed pan or urine bottle. If you find it difficult or too painful to pass urine, a temporary catheter (a small tube) may be placed in your bladder. The catheter should be removed after 24 hours.
Prevention of Pressure Sores
Due to the risk of developing pressure sores, you will need an air mattress. We will put cloth or plastic boots on your feet to protect your heels. It is important that you move your position in bed frequently. If you can not move yourself, the nursing team will help you. To be able to move around it is important that any pain is well controlled. If you are in pain, please let the nurses know.
Prevention of blood clots
You will be risk assessed and treated to prevent blood clots in the legs, with inflatable cuffs around your calves and/or daily injections of a blood thinning medicine (clexane). You will need to have the daily injections for 28 days following your operation.
Medical check and preventing further fractures
The specialist ward you have been admitted onto is managed by both Orthopaedic and Medical specialists.
A consultant doctor who specialises in Elderly Care Medicine (an ortho-geriatrician) and their team will also look after you on the ward. They will manage any medical issues you have. In particular, they will:
- Review you before surgery to ensure you are as medically fit as possible for your operation
- Investigate and treat any underlying medical conditions that may have caused your fall and if necessary arrange review in the falls clinic on discharge or other appropriate follow up
- Oversee your treatment if you become medically unwell
- Assess whether your bones are fragile and consider osteoporosis treatment
Some patients may experience a period of confusion after their operation. This can be caused by a number of factors such as being away from home, medication, blood imbalance, an infection or low oxygen levels. Whilst this can be distressing, it is usually short term and will be monitored, investigated and treated as necessary