Whether your fracture has caused damage to the blood supply to your femoral head will also help determine which type of surgery will be needed. The type of surgery required will depend on the severity of your fracture, your age, and underlying medical conditions. There are different types of surgery used to treat femoral neck fractures. These medications help strengthen your bones by increasing your bone density.Įmergency surgery is usually recommended for hip fractures to relieve pain and restore mobility as soon as possible. Your doctor may prescribe bisphosphonates and other osteoporosis medications to help reduce your risk of another hip fracture, depending on your age. This may include over-the-counter (OTC) pain medication, such as nonsteroidal anti-inflammatory drugs ( NSAIDs), or prescription drugs, such as opioids. Pain medication provides short-term relief from pain. Treatment of femoral neck fractures usually involves surgery, medication, and rehabilitation. ![]() However, there’s still the risk that the blood supply may be disrupted. If there’s no displacement, then surgically stabilizing the fracture with screws or other hardware may be done. The standard of care for a displaced fracture where the blood supply is disrupted involves replacing the femoral head ( hemiarthroplasty or a total hip arthroplasty). Fractures that occur in places where the blood supply is not disrupted have a better chance of healing.įor these reasons, treatment for an elderly patient with displaced femoral fractures will depend upon the location of the break and the quality of the blood supply. If the blood supply to the femoral head is lost, the bone tissue will die (a process called avascular necrosis), leading to the eventual collapse of the bone. They are more common in women.Ī femoral neck fracture can tear the blood vessels and cut off the blood supply to the femoral head. More than 90 percent of these fractures occur in people older than 50. ![]() Though anyone can fracture their femoral neck, it’s considerably more common in elderly adults who have poor bone density. basicervical is the base of femoral neck.transcervical is the mid portion of femoral neck.subcapital is the femoral head and neck junction.Fractures in this area are categorized based on the location of the fracture along the femoral neck: The capsule is the area that contains the fluid that lubricates and nourishes the hip joint. Just below the femoral head is the femoral neck.įemoral neck fractures are intracapsular fractures. This is the “ball” that sits in the socket. At the top of your femur (which is your thigh bone) is the femoral head. Your hip is a ball and socket joint where your upper leg meets your pelvis. Recognition of the appearance of subcapital hip fractures mimicking pathologic fractures and knowledge of the cause of this finding are important for prescribing appropriate treatment.The femoral neck is the most common location for a hip fracture. This appearance is caused primarily by rotation of the fracture fragments, and the finding is accentuated by displacement. The radiographic appearance of subcapital fractures of the femoral neck unrelated to neoplasm is often similar to that of pathologic fractures. Study of the cadaveric femoral specimens showed that the radiographic appearance simulating a pathologic fracture was primarily caused by external rotation of the distal fracture fragment and was accentuated by displacement between fracture fragments. This finding occurred only with Garden stage III fractures (n = 7, 32% of Garden stage III fractures) or Garden stage IV fractures (n = 10, 24% of Garden stage IV fractures). Seventeen (17%) of the 100 subcapital fractures had a radiographic appearance similar to that of a pathologic fracture. Cadaveric femurs (n = 6) were fractured and studied radiographically. ![]() Fracture configuration was classified by using the Garden staging system. Preoperative radiographs were analyzed for the presence of findings suggesting a pathologic fracture. In the other patients, follow-up radiographs, clinical evaluation, and pathology reports were used to exclude neoplastic involvement. Review of intraoperative biopsy specimens, available in 69 patients, revealed no evidence of neoplasm in any case. Radiographs were available in 100 of these cases. Our purpose was to determine the prevalence of this finding and the anatomic variations of fracture alignment that cause this appearance.Īll subcapital nonpathologic hip fractures (n = 111) that occurred at our institution during a 5-year period were reviewed. Occasionally, radiographs of the hip in these patients show a radiolucency in the superolateral, subcapital region of the femoral neck that mimics the features of a pathologic fracture. Subcapital fractures of the femoral neck are common in elderly persons who have osteoporosis.
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