About the disease
A femoral neck fracture is an injury of the femoral neck, which is the bone that connects the femoral head with the femoral shaft. They are located at the highest point of the thigh. The femoral neck supports the femoral head and femoral shaft.
Femoral neck fractures most often occur in young athletes who run professionally and in older osteoporotic patients. It can also develop because of low bone mineral density, causing a decreased supply of blood to the femoral neck. In some cases, a femoral neck fracture is caused by trauma. According to American medical site MedScape, femoral neck fractures are representative of 5-10% of all stress fractures.
A femoral neck fracture can be especially dangerous if it occurs in older people. If not treated, it can be terminal. The risk of mortality is 1 to 10% for in-hospital patients diagnosed with a hip fracture and who are older than 60 years. Nevertheless, modern treatment techniques are expected to lower the mortality rate in the near future.
Symptoms
- Hip pain
- Lower back pain
- Intolerance to cold temperatures
- Fatigue
- Disruption in menstrual cycle in women
- Restricted hip motion
- Inability to walk long distances
The onset of pain is usually gradual and it develops over several weeks before it becomes intolerable. It usually subsides when a patient sits down or rests and increases while exercising.
Diagnosis
In most cases, doctors use imaging tests to diagnose a femoral neck fracture.
- Radiography, an X-Ray of the hip, is the most commonly used diagnostic method for hip fractures, as it can create a precise image of the fracture.
- A CT scan can detect abnormalities in a patient’s bone structure and determine the extent of the fracture.
- An MRI Scan is especially effective in the diagnosis of stress fractures and it can also determine changes in the patient’s bone marrow that may have been caused by a femoral neck fracture.
Treatment
Before deciding which type of surgery is the best for you, you should consult an orthopedist. Treatment also depends on the patient's age and the extent of the fracture.
- Internal fixation of the hip is a type of surgery during where the surgeon lines up the pieces of the bone using special metal plates or rods. These metal plates can hold the femoral neck and femoral head together and return the patient’s hip flexibility.
- Hip replacement is a surgery during which the surgeon replaces the affected hip with a new one, which is usually made from metal or plastic components. The surgeon makes an incision along the side of the hip. It is usually performed under general anesthetic.
After surgery, you may need to undergo physical therapy, which is a part of orthopedic rehabilitation. If the surgery was successful, you will be able to return to taking part in sport if you are an athlete, but you will need to reduce the physical load.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed
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