Femoral Neck Fracture - Fracture of Hip

As life expectancy rises, the typical diseases of old age are becoming increasingly frequent. The fracture of the femoral neck (hip fracture) is one of many examples.

Hip anatomy
Hip anatomy

The natural weakness of the bones by aging, loss of muscle strength, greater difficulty to maintain balance, loss of visual acuity and the frequent use of drugs that cause blood pressure reduction or that act on the central nervous system favoring the fall and the resulting hip fracture in older people.

In this article we will explain what the femoral neck fracture, what are the implications and what are the treatment options.

What is hip and femoral neck?

Before we talk specifically the femoral neck fracture, it is essential to lose a few lines explaining the anatomy of the femur and the hip. Follow the illustration below to facilitate understanding.

The femur is the largest, bulkier and stronger bone in our body. It is located in the thigh, connecting the lower end to the knee and pelvis at the upper end. In this upper end, the femur has a bony projection, divided into 3 parts: head of the femur, femoral neck (also called the femoral neck) and increased trocante.

The head of the femur has a ball shape and fits perfectly into the bone of the pelvis, in a place called the acetabulum. This region, made up of the side of the bone of the pelvis and the upper end of the femur, is called hip or hip. Femoral head of the junction with the acetabulum is called the hip joint.

Femoral neck fracture

Despite being a very strong bone, femoral neck region is very susceptible to fractures, especially in older women with osteoporosis. the hip region of the injuries caused by falling are the main cause of femoral neck fracture.

Unlike fractures of other bones that occur by trauma in younger people, a hip fracture is a picture much more serious and complicated. Do not just immobilize the bone to cure a femoral neck fracture. Treatment should be done through surgery with placement of plates, screws or metal prostheses, and full recovery is very slow and can last for several months. Many patients are unable to walk again and become dependent on aid to perform their common life activities. Since this lesion usually runs in the elderly and patients already associated with some diseases, the rate of serious complications in the short and medium term is high, causing mortality in the range of 1 year after the fracture reaches 20%.

Risk factors for femoral neck fracture

The femoral neck fractures usually occur when two factors act together: trauma of the hip region (in most cases due to falls from standing height) and weak bones.

Therefore, as mentioned above, the elderly are the main risk group, as well as having a higher rate of osteoporosis, the incidence of falls is much higher in this age group.

Any factor that contributes to weakening of the bones or to a higher risk of falls can be regarded as a risk factor for hip fracture, particularly if they are present in older people. Some examples are:
  • Chronic use of drugs that weaken the bones, such as:. Glucocorticoids, heparin, warfarin, phenytoin, methotrexate, and several others that favor the onset of osteoporosis
  • Use of drugs that cause drowsiness, which lower blood pressure or reduce reflections because they increase the risk of falls.
  • Sedentary lifestyle, because the lack of activities leaves the bones and weak muscles.
  • Vitamin D deficiency, because the lack of this vitamin is related to the occurrence of weaker bones
  • Menopause, also related to bone loss
  • Multiple myeloma, being a disease that attacks the bones and facilitates the occurrence of fractures
  • Smoking and alcoholism because they are associated with bone loss.

The weaker the bone, the smaller the impact required for a fracture occurs. Often, the bone is so weak that a simple twist of the hip region may be sufficient to break it.

In healthy young people, femoral neck fracture occurs only in the event of major impact in the hip region, as in the case of car accidents.

Hip fracture types

Hip fractures usually occur in the femoral neck region, however, there are other points of the femur bone that may also leave. Knowing what type of hip fracture that the patient suffered is important because the treatment and the incidence of complications vary according to the fractured anatomical site.

Fractures of the neck and the femoral head are called intracapsular fractures. Fractures that occur below the femoral neck are called extracapsular fractures.
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