Femoral Neck Fracture Overview
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Femoral Neck Fracture Overview

Learn about the structure of the femoral neck, common occurrence in elderly women, risks such as avascular necrosis, and more in this introductory quiz.

Created by
@IndebtedNessie

Questions and Answers

What is the most common age group affected by basal and basicervical fractures?

7th & 8th decade

Which of the following is not a clinical feature of displaced fractures?

No obvious clinical deformity

What is a common risk factor associated with basal and basicervical fractures post menopause?

Osteomalacia

What does ORIF stand for in the context of fracture treatment?

<p>Open Reduction and Internal Fixation</p> Signup and view all the answers

Which treatment approach may be considered for non-ambulators with minimal pain and high surgical risk?

<p>Non-operative observation alone</p> Signup and view all the answers

What type of patient is ORIF indicated for in the context of basal and basicervical fractures?

<p>Young or physiologically young patients</p> Signup and view all the answers

Which symptom is typically associated with impacted and stress fractures?

<p>Pain in the entire hip region</p> Signup and view all the answers

What is a common cause of basal and basicervical fractures related to muscle health?

<p>Weak muscles</p> Signup and view all the answers

What is a potential cause of basal and basicervical fractures related to endocrine health?

<p>Diabetes</p> Signup and view all the answers

What is the typical presentation of displaced fractures in terms of leg positioning?

<p>External rotation and abduction</p> Signup and view all the answers

Study Notes

Basal/Cervical Fractures

  • Occur mostly in the elderly (7th & 8th decade) due to weak muscles, poor balance, osteomalacia, diabetes, stroke, and chronic debilitating diseases.
  • Common causes include falls from height, road traffic accidents, and minor trauma.
  • Symptoms include slight pain in the groin or referred pain along the medial side of the thigh and knee in impacted and stress fractures.
  • Physical exam may show no obvious clinical deformity, minor discomfort with active or passive hip range of motion, and muscle spasms at extremes of motion.

Treatment

  • Non-operative observation alone may be considered in non-ambulatory patients with minimal pain and high risk for surgical intervention.
  • Operative treatment involves Open Reduction and Internal Fixation (ORIF) for displaced fractures, especially in young or physiologically young patients.

Femoral Neck Fracture

Introduction

  • The head and neck of the femur are structured for efficient transmission of body weight with minimum bone mass.
  • Fracture of the neck of the femur is most common in elderly women, especially those over 70 years of age.

Epidemiology

  • Incidence is high and increasing due to an aging population.
  • Demographics show that women are more affected than men, and Caucasians more than African Americans.
  • The United States has the highest incidence of hip fracture rates worldwide.

Surgical Anatomy

  • The neck of the femur connects the Head of the Femur and the Shaft.
  • It is cylindrical, projecting in a superior medial direction at an angle of approximately 135 degrees to the shaft.
  • The neck has two borders and two surfaces, strengthened by the calcar femorale.

Risk Factors

  • Female sex
  • White race
  • Increasing age
  • Poor health
  • Tobacco and alcohol use
  • Previous fracture
  • Fall history
  • Low estrogen level

Pathogenesis & Mechanism of Injury

  • The femoral neck has limited healing potential due to its intracapsular location, lack of periosteal layer, and limited callus formation.
  • Associated injuries include femoral shaft fractures (6-9% associated with femoral neck fractures), which should be treated first.
  • Fracture location can be classified into intracapsular (sub-capital and trans-cervical) and extracapsular types.

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