Under the fracture of the femoral neck

A fracture of the femoral neck means a violation of the anatomical integrity of the femur in the zone of smooth transition of its head into the body.

Causes and predisposing factors

The main cause of the fracture is traumatic impact on the femur. In most cases, the vector of impact force is directed along the axis of the hip, but its perpendicular direction is also possible (for example, a blow to the area of the neck or hip joint itself).

The main predisposing factor is a change in the properties of bone tissue, which may be due to systemic pathologies or its rarefaction due to osteoporosis. Most often, this pathology occurs in women who are in the menopausal period, which is explained by hormonal changes occurring in their body.

Leading symptoms

The main clinical signs of this pathology are pain syndrome and loss of the ability to make free movements of the lower limb on the side of the lesion.

Often the patient notes the connection of the appearance of these symptoms with traumatic effects.

An increase in the intensity of pain occurs with a vertical load on the affected limb, when trying to make movements in the hip joint. Pain can radiate to the inguinal region, to the sacrococcygeal joint, to the shin area.

Diagnosis of pathology

When making a diagnosis, the doctor takes into account the characteristic subjective signs and objective examination data: a vicious position and a decrease in the length of the lower limb, the inability to perform active movements in it. A characteristic clinical sign is the inability of the patient to lift his leg up when in a horizontal position

The results of X-ray examination of the femur and magnetic resonance imaging are of crucial importance during the diagnostic search.

Basic principles of treatment

Surgical and conservative methods of treatment are used to combat this pathology. Conservative therapy in most cases does not bring positive results. It boils down to the immobilization of the affected limb with a plaster coxit dressing, the use of drugs that accelerate the regeneration of bone tissue – in particular, chondroprotectors. The disadvantages of this method are the high risk of developing pressure sores and persistent immobilization of the limb due to atrophy of the muscular apparatus.

More effective methods are:

restoration of the anatomical integrity of the femur with the help of special (metal) structures – metallosteosynthesis;
replacement of the damaged part of the bone with an all-metal or partially ceramic prosthesis;
formation of a false hip joint surgically (used when it is impossible to install a prosthesis).
The most common complication of surgical treatment is osteomyelitis of the femur. During prosthetics, rejection of the prosthesis by the patient’s body is possible.

Prevention

The main measure of prevention of this pathology is the prevention of changes in the structure of bone tissue. To this end, with a high risk of developing osteoporosis, in old age, it is recommended to adhere to a diet rich in calcium and vitamin D, and, if necessary, to carry out preventive intake of drugs containing these substances.

In addition, it is necessary to adhere to the normal parameters of body weight, since overweight significantly increases the risk of bone thinning and femoral neck fractures

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Under the fracture of the femoral neck

Under the fracture of the femoral neck

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