- open reduction and internal fixation of a hip fracture
- surgical pinning of the hip
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.
Professional Guide to Diseases, Sixth Edition. Springhouse: Springhouse Corporation, 1998.
Maher, Ann. Orthopedic Nursing. Philadelphia: W.B. Saunders Company, 1994.
Manual of Nursing Practice, 5th edition, J.B. Lippincott Company, 1997
Thompson, June, Mosby's Clinical Nursing, 4th edition, Mosby 1994.
Griffith, H. Winter. Instructions for Patients. Philadelphia:W.B. Saunders Company,1994.