A femoral neck fracture is a break of the thigh bone (femur) at the hip. The hip joint is a ball-and-socket joint. The break occurs at the neck, which is the part just below the ball. The blood supply to the broken bone is often interrupted, so these fractures have trouble healing. Most people do have a complete recovery after surgery.
The cause can be a severe fall or an auto accident. More often, older people, especially women, have these fractures. They result from osteoporosis (thinning of bone) related to aging. If the bone of the hip is thin enough, even twisting can break the bone. People may twist while standing, which breaks the bone, and then they fall. As many as one quarter of all women older than 75 may have severe enough osteoporosis to have a hip fracture.
Symptoms are pain in the hip, buttock, or pubic area, especially with movement of the hip or leg. The affected leg is shorter than the other leg, and the foot turns in. Later, bruising on the hip, especially in thin people, can be seen.
The health care provider makes a diagnosis from the physical examination and x-rays of the hip.
Treatment is nearly always surgical. Pins can be placed across the fracture, or metal plates and screws can be used to hold bone fragments together. Other choices include replacing the ball of the joint with a metal one, and replacing both the socket and the ball. Sometimes, surgery doesn’t make the joint stable, usually because the bone that’s left is too thin.
For people who are very sick, treatment may be bed rest to try to let the fracture heal.
The best ways to prevent hip fractures are to prevent and treat osteoporosis with diet, exercise, and medicine. Also, make sure that the home environment is safe.
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Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.
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