Hip fracture

Take immediate action

A hip fracture should be treated quickly and correctly—the hip is the body’s connection to the legs and is crucial for movement.

If you think your child has broken his hip, you should take him to the Emergency Room. If you’re waiting to see your child’s doctor, it may help to use self-care first aid remedies to reduce swelling and pain:

• rest: Make sure he doesn’t exert his leg without support; he can use crutches or a cane, if it helps.
   
• ice: Wrap a towel around ice cubes, an ice pack or a frozen food package to ice the leg for 20 minutes at a time, at two-hour intervals.
   

How we’ll treat your child’s hip

Children’s Hospital Boston’s hip sub-specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care—to their young patients. How we’ll treat your child’s hip fracture depends on the location, complexity and severity of his break—as well as his age and overall health. Children’s orthopedic experts will provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care.

Our treatment goals are to:

• control your child’s pain
• promote healing
• prevent complications
• restore normal use of the fractured area

To restore your child’s use of his broken hip bone, his doctor may recommend some combination of these possible treatments:

• rest and ice packs to reduce swelling, redness and pain
   
• medication to:
   
• surgery: usually needed to put broken hip bone(s) back into place
  • in open reduction, the surgeon inserts metal screws and pins (internal fixation) to hold bone fragments in place to allow alignment and healing
     
• pelvic cast or sling: immobilizes the injured area to promote bone alignment and healing, while also protecting the injured area from motion or impact; at Children’s, our experts fit your child for his cast or sling
   
• physical therapy: may be needed to strengthen your child’s muscles and help his hip return to full function
   

Care after surgery: tips if your young child is in a cast

• Keep your child’s cast clean and dry.
• Check for cracks or breaks in the cast.
• Put pads on rough edges to protect the skin from scratches.
• Don’t scratch the skin under the cast by inserting objects inside the cast.
• Use a hairdryer placed on a cool setting to blow air under the cast and cool down the hot, itchy skin. Never blow warm or hot air into the cast.
• Cover the cast while your child is eating to prevent food spills and crumbs from entering the cast.
• Prevent small toys or objects from being put inside the cast.
• Elevate the cast to decrease swelling.
• Encourage your child to move his toes to promote circulation.

Healing time after treatment

A hip fracture is a serious injury, and it usually means that your child will need surgery. There may be exceptions, but as a general guideline, the younger the child, the quicker he’ll heal.

• Children and teens typically need to be in a cast for four to six weeks after surgery.
• Infants, toddlers and very young children who are treated non-surgically with a hip spica cast (a cast that includes the trunk of the body and one or more limbs) often need less time to heal.
   

Coping and support

If your child or teen is being treated for a broken hip, the best thing you can do for him is to keep and model a positive attitude. Make a game out of keeping your small child’s cast dry during bathing. Start a countdown calendar for your teen to help him see progress toward getting back to normal—and toward getting back into his game if he plays sports.

Still, we understand that a hospital visit can be difficult. So, we offer many amenities to make your child’s—and your own—hospital experience as pleasant as possible. Visit the Center for Families for all you need to know about:

• getting to Children’s
• accommodations
• navigating the hospital experience
• resources that are available for your family
   

In particular, we understand that you may have a lot of questions when your child is diagnosed with a hip fracture. Will my child need surgery? How long will his recovery take? Will it affect my child long term? What should we do at home? Children’s can help you connect with extensive resources to help you and your family through this stressful time, including:

• patient education: From doctor’s appointments to treatment to recovery, our nurses and physical therapists will be on hand to walk you through your child’s diagnosis, treatment and recovery. And once your child is home, we’ll help you coordinate and continue the care and support he received at Children’s.
   
• parent-to-parent: Want to talk with someone whose child has been treated for hip dysplasia? We can often put you in touch with other families who’ve been through the same experience that you and your child are facing.
   
• faith-based support: If you’re in need of spiritual support, we’ll connect you with the Children’s chaplaincy. Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith traditions—who will listen to you, pray with you and help you observe your own faith practices during your child’s hospital experience.
   
• social work: Our social workers and mental health clinicians have helped many other families in your situation. We can offer counseling and assistance with issues such as coping with your child’s diagnosis, stresses relating to coping with illness and dealing with financial issues.

A long line of orthopedic firsts

With a long history of excellence and innovation and a team of clinicians and researchers at the forefront of orthopedic research and care, Children’s is home to many treatment breakthroughs:

• advanced techniques and microsurgery care for complex fractures and soft tissue injuries to the hand and upper extremity
• one of the first pediatric sports medicine clinics in the nation
• a hip program that has performed more than 7,000 periacetabular osteotomies
• advances in our spinal program, such as video-assisted thorascopic surgery

Children’s is also:

• the oldest and largest comprehensive center for the care of spina bifida
• one of the first scoliosis clinics in the nation

one of the first centers in the nation to use adjuvant chemotherapy and perform limb salvage surgery for patients with osteosarcoma.