Why Hip Injuries Are Feared

Dr. Kevin Ehrhart, The Early Show, 010115
The injury suffered by former President Reagan is extremely painful and debilitating, according to doctors who also say that Mr. Reagan's Alzheimer's Disease also may hamper recovery.

Dr. Kevin Ehrhart, chief of surgery at St. John's Health Center and the doctor who performed the surgery, said Mr. Reagan's hip was broken in the area where the muscles attach to the joint.

With this fracture, two parts of the hip are separated. During surgery, said Ehrhart, the parts are put back together and a device is screwed into the thigh bone, up across the fracture, into the ball of the hip joint. The side of the implant is then screwed to the shaft of the femur, the thigh bone, and that holds these two major pieces together while the bone heals.

"It also holds them together strong enough so the patient can begin walking and lastly, it holds them together so he's not having pain," Ehrhart said.

Mr. Reagan, who apparently tolerates pain well, is taking very little pain medication, Ehrhart said, which will help him recover faster.

Orthopedic surgeon Brad Penenberg explains that such hip repair is extremely painful, more painful than hip replacement, in which the damaged bone is removed. But the form of surgery Mr. Reagan underwent is the treatment of choice for this particular type of fracture, when the break is outside the hip joint.

Experts say 20 percent of people over 75 years old die after breaking a hip. The reason is immobility, which can lead to blood clotting, infection and heart and lung problems.

"You want to get him out of bed," Penenberg said of Mr. Reagan. "And I think he can pivot and transfer to a chair."

Although the normal hospital recovery period for this type of surgery is five to six days, Mr. Reagan may require hospitalization for a week to 10 days because of his age and his Alzheimer's disease.

"We said six to ten because he is older," Ehrhart said. "As soon as everything is going well with his non-orthopedic medical problems - heart, lungs and all is going well so far - we can concentrate solely on rehabilitation."

Rehabilitation could take months with continuous physical therapy.

Ehrhart said he likes to see patients go home as soon as possible. "As soon as he gets to his normal environment," the surgeon said of Mr. Reagan, "that is when the recovery goes the fastest."

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