Femoral Neck Fracture: Types, Symptoms, Treatment Options, and Recovery Process

Introduction

Femoral neck and peritrochanteric fractures collectively account for over 90% of proximal femur fractures, making them highly prevalent injuries.

The femoral neck is the most frequent site for hip fractures. The hip joint is a ball-and-socket structure connecting the upper leg to the pelvis. The 'ball' is the femoral head at the top of the thigh bone (femur), which fits into the socket. Just below this head lies the femoral neck.

These fractures are classified as intracapsular because they occur within the joint capsule, the area containing fluid that lubricates and nourishes the hip. Based on fracture location along the femoral neck, types include:

• Subcapital: at the junction of the femoral head and neck
• Transcervical: midsection of the femoral neck
• Basicervical: base of the femoral neck

While femoral neck fractures can happen to anyone, they are significantly more common in older adults with reduced bone density. Over 90% of cases occur in individuals aged 50 and above, with women being more frequently affected.

These fractures may disrupt blood vessels supplying the femoral head, potentially causing avascular necrosis—bone tissue death leading to collapse. Fractures that do not impair blood flow have a higher healing potential.

Treatment decisions for displaced fractures in elderly patients depend on fracture location and blood supply integrity.

Standard care for displaced fractures with compromised blood flow often involves replacing the femoral head through hemiarthroplasty or total hip arthroplasty. If the fracture is nondisplaced, surgical stabilization using screws or other hardware may be sufficient, though blood supply disruption remains a risk.

Causes of Femoral Neck Stress Fractures

Trauma is the leading cause of femoral neck fractures. Risk factors include age over 50 and medical conditions like osteoporosis that weaken bones. Bone cancer also increases fracture risk.

In older adults, falls are the predominant cause, whereas younger individuals typically sustain these fractures from high-impact events such as vehicle accidents or falls from significant heights.

Femoral neck fractures are uncommon in children but can arise from high-energy trauma or conditions that reduce bone density, such as osteopenia, osteoporosis, cerebral palsy, or muscular dystrophy.

Symptoms of Femoral Neck Fracture

The hallmark symptom is groin pain that intensifies with weight-bearing or hip rotation. Individuals with weakened bones may experience persistent groin discomfort before the fracture occurs.

Physical signs include a leg that appears shorter than the unaffected side or external rotation of the leg, with the foot and knee turned outward.

Diagnosis of Hip Fractures

Doctors typically identify hip fractures through physical examination, assessing hip and leg positioning alongside symptom evaluation. X-rays confirm the fracture and pinpoint the affected hip area.

Small or incomplete fractures might not be visible on X-rays. If symptoms persist despite normal imaging, advanced diagnostics such as CT scans, MRI, or bone scans may be necessary for detailed assessment.

Treatment Approaches for Femoral Neck Fractures

Management usually combines surgery, medications, and rehabilitation.

Pain relief is provided through over-the-counter options like NSAIDs or prescribed opioids for more severe discomfort.

Doctors may recommend bisphosphonates or other osteoporosis treatments to strengthen bones and reduce future fracture risk, tailored to patient age and condition.

Emergency surgery is commonly advised to alleviate pain and restore mobility promptly. Surgical choice depends on fracture severity, patient age, and overall health.

The presence or absence of blood supply damage to the femoral head guides the surgical method.

Internal Fixation

This technique uses metal pins or screws inserted into the bone, sometimes attached to a metal plate along the femur, to stabilize the fracture for healing.

Partial Hip Replacement

Partial replacement involves removing the femoral head and neck and substituting them with a metal prosthesis. It is typically chosen when bone ends are damaged or displaced, or for patients with significant medical issues where total replacement isn't ideal.

Total Hip Replacement

Total hip arthroplasty replaces both the upper femur and the hip socket with prosthetic components. Studies show this approach offers the best long-term results for otherwise healthy, independent individuals and is cost-effective by reducing the need for future surgeries.

Recovery Timeline for Femoral Neck Fractures

Recovery duration varies based on fracture complexity, patient health, and surgical treatment type.

Post-hospital rehabilitation is essential, with some patients returning home and others requiring specialized facilities.

Physical therapy is critical to regain strength and walking ability, often taking up to three months. Most patients regain substantial, if not full, mobility after surgery.

Summary

Femoral neck fractures predominantly affect older adults with compromised bone strength due to medical conditions.

Preventative measures include engaging in weight-bearing exercises to enhance bone strength and taking calcium supplements to improve bone density.

If you experience persistent groin or hip pain or are concerned about fracture risks, consult a healthcare professional promptly for evaluation and management.

Explore useful articles in Sexual Wellness as of 15-12-2018. The article titled " Femoral Neck Fracture: Types, Symptoms, Treatment Options, and Recovery Process " offers in-depth analysis and practical advice in the Sexual Wellness field. Each article is carefully crafted by experts to provide maximum value to readers.

The " Femoral Neck Fracture: Types, Symptoms, Treatment Options, and Recovery Process " article expands your knowledge in Sexual Wellness, keeps you informed about the latest developments, and helps you make well-informed decisions. Each article is based on unique content, ensuring originality and quality.