How Quickly Should a Broken Hip Be Operated On?

Most people with a broken hip need hip fracture surgery within 24 to 48 hours after the injury. Early treatment lowers the risk of complications such as blood clots, pneumonia, pressure sores, and urinary tract infections. It also helps reduce pain, restore mobility, and improve long-term recovery.

At Total Orthopedics and Sports Medicine, our surgeon, Dr. Charles Ruotolo, evaluates your fracture and provides prompt surgical treatment. Using advanced surgical techniques, he stabilizes broken bones, restores proper alignment, and helps relieve pain. We also accept insurance plans to prevent delays in your treatment. Call 855-321-6784 for immediate surgical treatment in East Meadow.

When Is Surgery Recommended for a Broken Hip?

Doctors usually recommend hip surgery within 24 to 48 hours when the broken pieces of bone have shifted out of alignment after an injury. They may also recommend surgery if the fracture affects the upper part of the thigh bone (femur) and restricts blood flow to the hip joint. In fact, NIH research reports that surgery within 24 to 48 hours can reduce the risk of death during the first year after injury by about 20%.

In this meta-analysis, researchers reviewed 28 studies involving 31,242 older patients with acute hip fractures. They found that early surgery reduced complications to 8%, compared with 17% in patients who received delayed treatment. Researchers also report that delayed treatment was associated with a higher risk of pressure sores and other recovery-related complications.

What Are the Risks of Delaying Hip Fracture Surgery?

Delaying hip fracture surgery can increase the risk of death, Deep Vein Thrombosis (DVT), and pneumonia. Prolonged immobility may also lead to pressure sores, pulmonary embolism, and poor blood circulation. Beyond this, delayed surgery leads to significant muscle loss and increases the risk of post-operative delirium (sudden confusion after surgery), especially in older adults.

Here is how these complications can affect your recovery and overall health after a hip fracture:

Deep Vein Thrombosis (DVT)

Extended bed rest after a hip fracture slows blood circulation in the legs. As circulation decreases, blood clots may develop in the deep veins of the affected leg. In such cases, you may notice swelling, warmth, pain, or tenderness in the calf. Without prompt treatment, the clot may travel to other parts of the body and cause potentially life-threatening conditions such as:

• Pulmonary Embolism: A clot blocks blood flow in the lungs.
• Severe Breathing Difficulties: Reduced oxygen levels make breathing more difficult.
• Heart Complications: Blocked blood flow places additional strain on the heart.
• Sudden Collapse: Severe clots may cause fainting, dizziness, or shock.
• Death: Untreated pulmonary embolism may become fatal in severe cases.

Muscle Loss and Frailty

Delays in surgery often lead to prolonged immobility, which can cause rapid muscle loss in the affected leg. You may notice increasing weakness that makes standing, walking, and other daily activities more difficult. This loss of strength often slows rehabilitation after surgery because the muscles provide less support around the hip joint. Over time, reduced activity may impair circulation and increase frailty (physical weakness), especially in older adults.

Pressure Sores

Prolonged bed rest can place constant pressure on the skin and soft tissues between the bed and the underlying bone. As this pressure increases, blood flow to these areas gets restricted, which reduces the oxygen supply. Without adequate circulation, the skin and deeper tissues begin to break down, especially around the hips, heels, ankles, and tailbone. This damage may progress from skin discoloration and blisters to deep wounds that require urgent treatment.

Post-Operative Delirium

According to a study published in Geriatric Orthopedic Surgery & Rehabilitation, post-operative delirium affects 4% to 53% of older patients after hip surgery. Ongoing pain and delays in treatment may contribute to this complication by placing additional strain on the body. As a result, you may experience confusion, difficulty concentrating, or sudden changes in awareness after surgery. The study also found that patients with delirium often have longer hospital stays and a higher rate of medical complications during recovery. These symptoms may delay rehabilitation and increase the risk of long-term cognitive decline.

How Does Age Affect Hip Fracture Surgery Timing?

Older adults often need faster coordination and careful preoperative planning because aging reduces the body’s ability to recover from injury. Older adults also face a higher risk of complications and loss of mobility after a hip fracture. For this reason, doctors usually recommend hip fracture surgery within 24 to 48 hours. However, the exact timing may vary if chronic illnesses such as heart disease, lung disorders, or uncontrolled diabetes require stabilization before surgery.

In fact, a study by Dr. Charles Ruotolo et al. reviewed 412 older patients with hip fractures and found that unnecessary cardiac testing often delayed surgery. After analyzing the data, the researchers reported the following findings:

• Cardiology consultations increased surgical wait times from 19.27 hours to 25.42 hours.
• Echocardiograms (heart ultrasounds) increased surgical wait times from 18.94 hours to 26.00 hours.

Similarly, patients taking blood-thinning medications may need extra time before surgery to reduce the risk of excessive bleeding during the procedure. Because these factors can affect surgical timing, geriatric teams often work closely with surgeons to coordinate care and ensure patients are safely prepared for surgery.

Do All Hip Fractures Require Surgery?

No, doctors do not always recommend surgery for a hip fracture. For example, non-displaced or hairline fractures may heal with conservative treatment such as pain management and limited weight-bearing because the broken bone maintains its normal alignment. A fellowship-trained hip specialist may also avoid surgery in patients with severe heart, lung, or other serious medical conditions that make anesthesia unsafe. However, these cases require regular monitoring to ensure proper healing and prevent the fracture from shifting out of alignment.

What Tests Are Done Before Hip Fracture Surgery?

Before hip fracture surgery, our surgeon, Dr. Charles Ruotolo, usually recommends X-rays to confirm the fracture and determine its exact location. He may also order an MRI or CT scan for a more detailed view of the surrounding tissues. If needed, he may request blood tests, such as a Basic Metabolic Panel (BMP), to assess for infection, blood loss, kidney function, and electrolyte balance.

In addition, coagulation studies evaluate your blood-clotting function and help identify any risk of excessive bleeding during surgery. If you have breathing problems, Dr. Charles Ruotolo may also order an Arterial Blood Gas (ABG) test to evaluate oxygen levels before general anesthesia. Beyond these evaluations, our hip specialist may also recommend the following tests to reduce the risk of complications:

Electrocardiogram (ECG/EKG)

An Electrocardiogram (ECG/EKG) measures the electrical activity of your heart. This test helps identify abnormal heart rhythms or signs of a previous heart attack. The test can identify irregular heart rhythms and other cardiac abnormalities that may affect surgical outcomes. This information helps your care team minimize risks and plan the safest possible surgery.

Lung Function Assessment

According to the National Library of Medicine, pulmonary evaluation helps reduce respiratory complications before hip fracture surgery. During this assessment, our hip surgeon, Dr. Charles Ruotolo, reviews your medical history, performs a lung examination, and measures your oxygen saturation (oxygen level in the blood). This evaluation helps identify chronic lung conditions and other breathing problems before surgery, such as:

• Chronic Obstructive Pulmonary Disease (COPD)
• Asthma
• Chronic Bronchitis
• Emphysema
• Pneumonia
• Pulmonary Fibrosis
• Sleep Apnea
• Low Blood Oxygen Levels (Hypoxemia)
• Respiratory Infections

Echocardiogram

Our surgeon, Dr. Charles Ruotolo, often orders an echocardiogram if you have a history of heart disease or heart failure. This test uses sound waves to create detailed images of your heart and evaluate its pumping function. The results help your surgical team develop a multidisciplinary care plan that supports safer anesthesia, smoother recovery, and better overall outcomes.

MRSA Screening

MRSA screening uses a simple nasal swab to detect antibiotic-resistant bacteria. Identifying these bacteria before surgery helps reduce the risk of surgical site infections. If your test result is positive, your care team can take additional precautions and adjust your treatment plan before the procedure. This proactive approach helps protect you from infection-related complications and ensures safety during recovery.

How Do Orthopedic Surgeons Fix a Broken Hip?

Orthopedic surgeons usually repair a broken hip with metal hardware or replace the hip joint. However, the exact surgical procedure depends on the type of fracture, your age, and the condition of the hip joint. For minor fractures, surgeons use metal screws, plates, rods, or nails to hold the broken bone in proper alignment while it heals. However, if the femoral head (the ball of the hip joint) is severely damaged, they may recommend a partial or total hip replacement. Here is how these procedures repair the damaged bone and support recovery:

Hip Pinning

If the fracture fragments are properly aligned, your surgeons may recommend hip pinning to stabilize the bone. During this procedure, they place metal pins, screws, or small plates across the fracture site. These implants hold the fracture in position while the bone heals naturally. As a result, you can begin recovery with better stability around the injured area.

Internal Fixation

Internal fixation stabilizes the fracture using metal screws, plates, rods, or intramedullary nails (rods placed inside the bone). Surgeons often use this technique for intertrochanteric fractures and other unstable fracture patterns. These implants keep the bone fragments aligned and prevent movement during healing. This approach may also support earlier mobility and overall well-being after surgery.

Partial Hip Replacement

If the upper part of your thigh bone is severely damaged, your surgeon may recommend a partial hip replacement. During this procedure, they replace only the damaged femoral head (ball of the hip joint) with an artificial implant. As a result, you may experience less blood loss, a shorter operation, and a faster recovery period.

Total Hip Replacement

A total hip replacement replaces both the femoral head and the hip socket with artificial implants. Surgeons may recommend this procedure if the fracture causes extensive joint damage or advanced arthritis in the hip joint. By replacing both parts of the joint, this procedure restores hip joint stability, improves function, and enhances overall mobility. However, you may need a longer recovery period to regain strength and mobility after surgery.

How Long Does Hip Fracture Surgery Take?

Hip fracture surgery usually takes 1 to 3 hours, depending on the type of fracture and the procedure performed. For example, internal fixation or hip pinning often takes 45 minutes to 2 hours. In contrast, a partial or total hip replacement may take 1.5 to 3 hours because it involves removing damaged bone and positioning artificial implants.

In addition, the following factors may affect the complexity of the procedure and extend the overall surgical time:

• Complex Fracture Patterns: Complex fractures require more time because surgeons must carefully align the broken bone.
• Multiple Broken Bone Fragments: Several bone fragments increase surgical complexity and require additional fixation.
• Your Age and Overall Health: Your age and overall health may require additional monitoring before and during surgery.
• Pre-Existing Medical Conditions: Conditions such as heart disease or diabetes may require extra precautions during the procedure.
• The Type of Anesthesia Used: Different anesthesia options require specific preparation and monitoring.

What Is Recovery Like After Hip Fracture Surgery?

Most patients stay in the hospital for 3 to 5 days after hip fracture surgery. During this time, your care team begins pain management and guides you in using assistive devices such as a walker or a cane. As recovery progresses, you can often resume light daily activities within 6 to 12 weeks. Although the bone often heals within 10 to 12 weeks, many patients need at least 6 months to regain strength and mobility.

However, full recovery may take 3 to 12 months, depending on your overall health and the type of fracture. Throughout the recovery period, your surgeon may also recommend at-home exercises to support opioid reduction, improve strength, such as:

• Ankle Pumps: Move your feet up and down while lying on your back to improve circulation and help prevent blood clots.
• Thigh Squeezes: Tighten the thigh muscle of your operated leg and hold for 5 seconds to strengthen the upper leg.
• Heel Slides: Slide your heel toward your buttocks and back down to improve knee and hip flexibility.
• Buttock Squeezes: Squeeze your buttock muscles for 5 seconds and then relax to improve hip stability.

How Soon Can You Walk After Broken Hip Surgery?

Most patients begin walking within 24 hours after hip fracture surgery. In the first 1 to 3 days, you will take a few assisted steps with the help of a physiotherapist and assistive devices such as a walker or crutches. However, the amount of weight you can place on your leg depends on the type of fracture and the surgical repair. As your strength and balance improve, you may progress from a walker to a cane over the following weeks. With consistent rehabilitation and guided mobility training, many patients walk independently within 6 to 12 weeks after surgery.

What Are the Success Rates of Hip Fracture Surgery?

Hip fracture surgery helps restore mobility, reduce pain, and improve daily function in about 80% to 90% of cases. In fact, a study published in BMC Musculoskeletal Disorders followed 5,079 patients who underwent surgical treatment for a hip fracture. The researchers reported a 10-year overall survival rate of 93.3% after surgery. They also found a 73.5% complication-free rate at 10 years.

However, the overall success rate also depends on factors such as your age, preinjury health, fracture type, and postoperative medical management. In addition, complications such as infection, blood clots, and anesthesia-related problems may affect recovery and long-term outcomes. These risks are often higher in older people with multiple medical conditions. For this reason, early surgery, proper medical management, and consistent rehabilitation are essential to improve long-term function.

We Can Help You Decide If You Need Hip Surgery — Visit Our Clinic in East Meadow!

Persistent hip pain after a fall often requires immediate surgical repair. At the same time, you may worry that existing heart, lung, or other medical conditions could affect your eligibility for surgery. You may also have concerns about pain relief, regaining independence, and returning to your normal routine after treatment.

As a Member of the Arthroscopy Association of North America (AANA), our surgeon, Dr. Charles Ruotolo, at Total Orthopedics and Sports Medicine, carefully evaluates your overall health and surgical risks before recommending surgery. He also discusses your mobility goals, activity level, and recovery expectations that may affect surgical planning. Based on this assessment, he selects the most appropriate procedure to restore function. Call 855-321-6784 or visit our clinic for fracture treatment.

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