Hip Fracture Surgery Duration: What to Expect for Different Procedures

Surgical time for hip fracture fixation varies by procedure type, fracture pattern, patient factors, and surgeon experience. Skin-to-skin times are estimates; total OR time adds anesthesia, positioning, prep, and turnover.

Typical Skin-to-Skin Duration

Procedure	Typical Duration	Indication
Hemiarthroplasty (bipolar/unipolar)	60–90 minutes	Displaced femoral neck fracture in elderly, low-demand, or cognitively impaired
Total Hip Arthroplasty (THA)	90–120 minutes (up to 150 for complex)	Displaced femoral neck fracture in active, healthy elderly; pre-existing arthritis
Dynamic Hip Screw (DHS) / Sliding Hip Screw	45–75 minutes	Stable intertrochanteric fracture (AO/OTA 31-A1/A2)
Proximal Femoral Nail (PFN / Gamma Nail)	60–90 minutes	Unstable intertrochanteric (A3) or subtrochanteric fractures
Cannulated Screws (Multiple)	30–60 minutes	Undisplaced/valgus-impacted femoral neck (Garden I/II), young patients

Factors Prolonging Surgery

• Obesity (BMI >35) – exposure, instrumentation difficulty
• Severe osteoporosis – fixation challenges, cement use
• Revision / conversion (failed fixation → arthroplasty)
• Combined fractures (ipsilateral femur shaft, pelvic ring)
• Anesthesia delays (difficult airway, hemodynamic instability)
• Trainee involvement (supervised)

Total OR Time (Door-In to Door-Out)

Add 45–75 minutes for: anesthesia induction/positioning (20–30 min), surgical prep/drape (10–15 min), closure (10–15 min), emergence/extubation (10–15 min), turnover.

Postoperative Timeline

• PACU: 1–2 hours
• Ortho floor / ICU: mobilization Day 0 or 1
• LOS: 3–5 days (hemi/THA), 4–7 days (nailing/DHS) – highly variable

Discuss the specific planned procedure, anticipated duration, and surgeon’s personal metrics during consent. Efficiency correlates with volume and specialization—high-volume hip fracture surgeons tend to be faster with fewer complications.