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Femoral Neck Fracture

What is a femoral neck fracture?

This is a break that occurs in the femur bone of your leg. The femoral neck fracture occurs just under the ball-shaped head that fits into your hip socket. It is a fracture that is commonly found in older individuals who are suffering from osteoporosis and athletes who play contact sports. When a person has a femoral neck fracture the ball will become disconnected from the rest of your femur. This type of fracture causes more hospitalizations than any other broken bone injury. It is an injury that occurs more in females than males and in Caucasians than other ethnic groups.

Anatomy

The femur is the strongest, thickest, and longest bone in your body and extends from your pelvis to the top of your knee. For an average size person this bone will typically measure about twenty inches. It is a critical component of the human body that ensures energy is distributed downward to your foot and gives support to your entire upper body. It has an essential role in someone walking, jumping, standing, and running. The main shaft of your femur is connected to the round head by the femoral neck. The femoral neck is a relatively thin section of bone.

Symptoms

When a person suffers from a femoral neck fracture there is immediate stiffness and pain. You will also be unable to bear weight on the leg or move it without extreme discomfort. The joint will usually swell.

Causes

The cause is usually due to direct trauma to the hip such as:

  • An athlete being hit from the side or falls awkwardly due to the sheer force of impact on their hip joint
  • Osteoporosis, which is a condition that leads to the fragility and erosion of bone tissue, even if the fall is minor or because of a sudden twist
  • Malnutrition
  • Poor vision
  • Disorders that affect your muscle stability
  • Obesity

Diagnosis

A femoral neck fracture is normally diagnosed by having x-rays taken.

Complications

With this type of fracture there is a primary concern that the damaged blood supply to the bone will lead to non-healing, even with surgery or other treatment. It can also lead to hip osteonecrosis, which is death of the femoral head. If this happens you may require hip replacement surgery later. When you have a femoral neck fracture you should not expect to regain the same level of physical activity that you had before the injury. Having one femoral neck fracture increases your risk of having another. Some suffer from depression because of the length of recovery and from the changes to your lifestyle and activity levels.

Treatment

When someone suffers a hip injury, it is essential to call an ambulance to take them to the hospital instead of someone else transporting them. The reason is that the leg should be immobilized to prevent damage to nearby tendons, ligaments, and the rest of their hip joint so it is best if they are placed on a stretcher to be transported. After the x-ray is taken, it will carefully analyzed to make sure that the blood supply has not been cut off and if it has then emergency surgery will be done to restore the flow of blood and prevent muscle and bone tissue death.

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In order to prevent further damage to your hip socket it is important to have an emergency evaluation. This will also help determine the most appropriate treatment. The surgeon can try to manually set the bone back into place and then wrap it in protective padding but usually you will have to undergo a surgical procedure in order to promote proper healing. It all depends on the severity of the injury. What treatment is used also depends on the age of the person. If you are under sixty to sixty-five years of age, the surgeon will try to avoid doing a partial hip replacement. The reason is that the prosthetic used in partial hip replacements seem to wear out in people who are younger and more active.

Surgery

There are two ways in which a surgeon can fix your femoral neck fracture. If it is a severe break or the bones are fragile because of osteoporosis the surgeon may need to replace your hip joint.

Hip pinning

he surgeon can pin your hip socket together using two or three metal screws through your hip joint and femoral head to keep your leg in place while it heals. This is normally done if the femoral neck fracture is minimally displaced and well aligned. In younger patients this may be attempted even if the bones do not properly aligned to avoid doing a partial hip replacement. If it does not work then a partial hip replacement might be necessary. When this method of treatment is used it is done under either spinal or general anesthesia. On the outside of your thigh the surgeon will make a small incision. Using x-ray the surgeon will pass several screws across the femoral neck fracture to stabilize the broken bones.

Hip hemiarthroplasty

This is a partial hip replacement and involves removing the surrounding hip socket and femoral head and inserting a lightweight metal prosthesis in their place. Many times this is the procedure that is used to treat a femoral neck fracture because of the problems with blood supply that is diminished when a person has this type of fracture. This procedure is also performed under spinal or general anesthesia. There will be an incision made over the outside of your hip to do the surgery. For patients with thinner, more osteoporotic bone the prosthetic stem can be cemented into the bone. If you have better bone quality it can be press-fit into the bone.

Prognosis

Even with physical therapy and careful monitoring it will usually take several months to recover from a hip injury. In most cases you can regain the ability to engage in a limited level of regular physical activity.


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