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Fractured Neck Of Femur : Definition, Causes, Symptoms, Diagnosis and Treatment

Friday, July 13th 2012. | Bone Health, Disease

Fractured Neck of Femur Definition

The femoral neck fracture is a crack near the hip joint, located between the top (head) of the bone of the leg and the main part of the latter. The femoral neck fracture often occurs in the elderly after a fall on the hip. Osteoporosis (bone degradation) contributes regularly to a broken bone. In severe osteoporosis, a simple’ bad’ movement may be enough to break a hip.

Younger patients suffer from a femoral neck fracture most often after a violent shock, such as during a car accident or skis to cause this injury, the pressure on a young leg must be extremely violent. A femoral neck fracture requires an operation in the hours following the accident, to prevent necrosis of the femoral head (degradation and death of part or all of the top of the femur).

Fractured Neck of Femur  Causes

Risk factors for falls in older people :

  • Unsteady gait
  • Vision problems
  • Balance problems (vertigo)
  • Attention disorders (eg, when dementia)
  • Weak muscles, slow reflexes
  • Low blood pressure (eg fall in blood pressure after having risen rapidly)
  • Drugs

Extreme environment (eg, fence, door sill, cable, slippery floor, humidity, low light, etc..)

Causes a fracture of the femoral neck :

  •  Fall on the hip in an elderly person
  •  Osteoporosis (bone degradation)
  •  Pressure extremely violent (eg car accident or ski) in young people

Fractured Neck Of Femur Disorders (symptoms)

  • Inability movements immediate and complete
  • Extreme pain in the hip area, the leg can not be waived.
  • Increasing pain to the touch; optionally a swelling on the side of the hip.
  • According to the fracture zone, the leg may be shortened and turned to the side.
  • In rarer cases, the leg can not be turned to the side and the pain may occur in the knee area; fracture risk of femoral neck and at first not to be suspected.
  • Injury of blood vessels and nerves tends to occur in young patients, that is to say, after a violent collision.

Fractured Neck Of Femur (img :uwo.ca)

Fractured Neck Of Femur Examinations (diagnosis)

  • Development of the accident, description and age of the patient almost immediately put the doctor on the right path
  • Diagnostic confirmation using radiography (X-rays) of the basin
  • Possibly a scanner (CT Computer Tomography)
  • Eventually an MRI (Magnetic Resonance Imaging), primarily to exclude other injuries in the hip area

Fractured Neck Of Femur Treatment Options

It is rare for a femoral neck fracture is stable enough to perform a conservative treatment (without surgery). An operation is necessary in most cases.

Conservative treatment (no surgery)

  • Bed rest for 10-14 days
  • Stabilization of the leg
  • Prevention (prophylaxis) of thrombosis
  • Possibly a respiratory therapy
  • After 2 or 3 days begin rehabilitation, first cautiously, then with a gradual increase of the load on the leg for 4 weeks.

Medical Drugs

  • Prevention of thrombosis
  • Optionally antibiotics in prevention of infection
  • Pain

Types of surgery

The selected type of operation depends on the overall health of the bone density and location of the fracture. In all cases, the operation should take place within 6 hours after the accident (risk of necrosis of the femoral head).

Insertion of a screw (Osteosynthesis) is only possible at a density sufficient bone (not osteoporosis).

Advantage : fast operation, low damage to surrounding areas, the natural joint of the leg (femoral head) remains in place.

Disadvantage : there is the risk of a mismatch of the fracture and the formation of a false joint (pseudoarthrosis). After this operation, the leg can not bear immediately on body weight.

Dynamic hip screw (metal plates and screws) : to stabilize, a metal plate is fixed to the upper leg and a thick is placed on the screw head of the femur. This operation is also possible that if the bone density is sufficient.

Advantage:  quick operation, the natural joint of the hip (femoral head) remains in place.
Disadvantage: a shift of the fracture may occur. A complete application of body weight is not immediately possible. There is also a risk of necrosis of the femoral head.

Artificial joint (prosthesis) of the hip : this type of operation is performed in elderly patients and with low bone density (osteoporosis). There are two possibilities: either a prosthetic femoral head is added to the main part of the leg bone (femur), which then slides into the hollow of the original hip joint, or the artificial joint complete – the femoral head and the hollow of the hip, that is to say a total hip replacement (PT) – is added.

Advantage : the leg can support the weight of the body shortly after surgery. Rapid recovery of the patient avoids prolonged bed rest and reduces the risk of complications (pneumonia, pulmonary embolism, pressure sores).

Disadvantage : bigger deal, big damage to surrounding areas. The hip prosthesis can deteriorate, requiring a new operation for the change.

Emergency (first aid)

In virtually all sports injuries, the immediate application of the following is required. It is essential to act quickly.

  • Break – immediate cessation of sporting activity during
  • Ice – cooling the injured area, if there is no open wound
  • Compression – a compression bandage prevents swelling and should be regularly checked.
  • Elevation – In case of injuries affecting the extremities (arms, legs), the elevation facilitates the return of blood and reduces the formation of edema. This measure does not of course for people who have lost consciousness or in case of suspicion of injury to the head, shoulders and back. If in doubt, apply an ice pack or put to rest the injured area and alert the doctor or the nearest hospital.

Fractured Neck Of Femur Possible Complications

The elderly often suffer complications due to disease present preoperatively (eg cardiovascular problems), duration of bed rest or trauma hip same :

Complications during or after surgery :

  • Lesions of vessels, nerves or tendons
  • Venous thrombosis in the leg / pulmonary embolism
  • Infections
  • Pneumonia (lung inflammation)
  • Shift of the fracture
  • Deterioration of the metal plate or the hip prosthesis
  • Formation of a false joint (pseudarthrosis)
  • Degradation (necrosis) of the femoral head
  • Healing problems
  • Bleeding
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