Hip Pinning

Alternate Names
open reduction and internal fixation of a hip fracture
surgical pinning of the hip

Definition of Hip Pinning

Hip pinning is a procedure used to repair a hip fracture, or broken hip. Pinning means that one or more special metal pins are inserted into a bone or bones.

Who is a candidate for the procedure?

A hip fracture is actually a break in the top part of the thighbone, also called the femur. Not every hip fracture needs pinning. A bone surgeon known as an orthopedist will determine if a fracture needs pinning. The decision is usually based on the location, type, and severity of the hip fracture. The hip pinning enables the hip to begin functioning and the person to move around earlier than if the bone had to heal on its own. Also, it can help reduce complications from prolonged bed rest.

How is the procedure performed?

Hip pinning is done in the operating room under general anesthesia or regional anesthesia. General anesthesia means the person is put to sleep with medications, feels no pain, and has no awareness of the procedure. Regional anesthesia usually means the person will be awake but numb below the waist. A medication may be given to make the person drowsy.

Once the anesthesia has started to work, the hip area is cleaned. An incision is usually made on the outside of the hip. In unusual cases, an incision is not made into the skin, and the bones are manipulated into the right position from the outside of the body. Joint X-rays are used to confirm that the bone pieces are in the right position.

Special metal pins are then inserted into the bone pieces to hold them together. In most cases, these pins are underneath the skin and cannot be seen after the operation. In some cases, the pins are inserted through the skin and can be seen after surgery. Other devices such as metal plates may also be needed to help hold the broken bone together.

After the bone is repaired, the incision is sewn closed. Special plastic tubes may be put through the skin incision and into the area of surgery. These act as drains to collect blood and other fluid that can build up after surgery. A dressing is then applied to the incision. The person is taken to the surgery recovery room. This procedure usually takes a total of 1 to 3 hours.

What happens right after the procedure?

After a hip pinning, the person needs to stay in the surgery recovery room for close observation. Blood pressure, pulse rate, breathing rate, and other body functions including the circulation and sensation in the legs and feet are monitored closely.

The person will receive fluids through an intravenous tube to replace those lost during surgery. The drain that was placed in the incision at surgery may be left in place to keep fluids from building up inside the wound. The individual may also have a urinary catheter to drain urine from the bladder.

After a short time, the person is taken to a hospital room on the orthopedic or surgical unit. Pain medications are given as needed. Antibiotics may be given to prevent or treat infections.

While in the hospital, the individual will have physical therapy. This involves learning to perform exercises to strengthen the hip. Most people will be able to leave the hospital within 5 to 7 days.

What happens later at home?

Before going home, the person should be able to get around using crutches or a walker. Physical therapy may still be needed after the person goes home. Some people need to go to a rehabilitation center after leaving the hospital. This helps them gain the independence needed to be able to get around at home. Full recovery from this surgery may take 3 to 6 months.

What are the potential complications after the procedure?

Surgery may be complicated by bleeding, infection, or a reaction to the anesthetic. Pain medications or antibiotics may cause stomach upset, allergic reactions, or rash.

The most common complications of a hip pinning are:

• blood clot in the leg, or deep venous thrombosis. To prevent blood clots, medications called blood thinners may be given. The person is asked to move around shortly after surgery and may need to wear support stockings.
• wound infection. To prevent this complication, antibiotics may be given.
• bleeding. Sometimes a blood transfusion may be needed.
• poor healing of the fracture

Any new or worsening symptoms should be reported to the healthcare professional.