Femoral Neck Fracture

Femoral Neck Fracture: Injuries are common problems that can await us at every turn: on the way to work, during rest, or at home.  For example, what is a hip fracture? How serious is this, and what is the essence of such damage?

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Causes of femoral neck fissure

Hip fractures can occur in a variety of circumstances – for example, in a traffic accident, at work or home, during a fight, while playing a sport, walking on a slippery or uneven surface. There may be additional reasons:

incorrectly selected intensity of sports training;
very intense exercise without prior preparation, warm up or stretching;
Wearing uncomfortable shoes or clothing increases the risk of falling.
Risk

• Vitamin D deficiency in the body;
• hypodynamia, low physical activity;
• lack of calcium in the body;
• lack of trace elements (copper, zinc, manganese), which leads to a violation of the formation of bone tissue;
• Vitamin K deficiency;
• protein deficiency;
• Above 50 years of age.

Pathogenesis

In most cases, femoral neck fractures are the result of osteoporosis, bone demineralization and other pathological processes that result in increased bone fragility.

It is impossible not to take into account the force factor in the development of the injury, however, sometimes a completely insignificant force effect is enough for the appearance of a crack. For example, older people can have both cracks and fractures, even after a normal fall.

In medical practice, the presence of a specific cause is not always clear, and many patients initially attribute hip pain to other factors. This greatly complicates both diagnosis and treatment. As a rule, a fall or other injury, followed by pain in the groin (especially when moving the leg), is a reason for the urgent appeal to a traumatologist.

Symptoms of femoral neck fissure

The non-specificity of the clinical presentation is a problem as patients delay visits to the doctor and the trauma worsens.

The negative point is that the fracture of the femoral neck sometimes practically does not manifest itself in any way. Especially often it occurs with minor injuries in people suffering from arthrosis or osteoporosis.

In general, traumatologists identify the following first signs of partial bone damage:

• Severe pain at the time of a fall or impact (later, it may be debilitating).
• Pain on the background of movement of the leg or when trying to lean on it.
• The victim is able to walk independently, but it is quite difficult to do so.
• The back muscles become sore and tense.

If a person has previously had problems with the hip joints – for example, suffered from arthrosis – he may take a crack in the femoral neck for exacerbation of the chronic disease. In such a case, it is important to associate the moment of appearance of the first symptoms with trauma, fall, etc. Another important detail: the symptoms of pain that accompany a hip fracture do not go away during the treatment of arthrosis, since traditional anti-inflammatory drugs cannot affect the healing of the damaged bone.

In favor of fractures, the following symptoms speak:

• The leg turns out to be unusual.
• Bleeding (bruising) or severe redness occurs.
• My legs are a bit short.
• A person, being in an upright position, cannot lift the heel and hold the limb underweight.
• Sometimes the body temperature rises.

Hip fracture in the elderly

Elderly people who have had a hip injury are at additional risk for the following reasons:

The older the patient, the greater the risk of developing complications, both physically and mentally.
Elderly people often have reduced immunity, chronic pathologies of the cardiovascular and respiratory systems, which can worsen against the background of trauma and prolonged sedentary position.
Older people almost always have joint problems, which can adversely affect the healing process of the crack.
Prolonged bed rest negatively affects the functioning of the cardiovascular and respiratory systems, muscle atrophy and stagnation occur.
Older people may become depressed, neurosis may develop. The lack of motivation and the depressed mood of the patient can negatively affect the prognosis of treatment.

Steps

The healing of a femoral neck fracture is conditionally divided into several stages - this is a direct bone injury, a restorative and remodeling stage.

So, the first stage is the moment of injury, at which there is a violation of the blood supply and a pathological process develops. Various mechanisms are involved – from inflammation to tissue necrosis. The less affected the circulatory system in the area of ​​damage, the better the treatment.

The recovery phase is accompanied by the processes of ossification of new cellular structures. If osteosynthesis progresses sufficiently, the damaged area will be replaced with young tissue: this process is called contact healing.

Bone callus is formed – an important factor in bone fusion. The new tissue covers the fracture site and acts as a base, like a biomatrix. This is essential for high-quality fusion and reconstitution of the fragment.

The formation of corns occurs as follows: in the area of ​​​​the crack, new cellular structures begin to actively divide, among them there is an overabundance, which subsequently serves as the base of the corn. Gradually, the corn changes its structure – from this moment they talk about the beginning of “fusion” of cracks. The callus of the bone turns into a spongy piece, calcium accumulates in it and strength increases.

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