Fractured Femoral Neck and Rehab

What happens to a broken femoral neck?

In the event of a femoral neck fracture (also called a femoral neck fracture or a femoral neck fracture), the femur breaks near the hip. The cause is usually a fall or accident. Older people are often affected because their bones are more fragile due to osteoporosis. Find out everything about the fracture of the femoral neck, therapy and rehabilitation here.

Femoral neck fracture: general

The bone of the thigh consists of several parts. The long, central area is called the shaft. At the top is the head, which is part of the hip joint. The neck is the angled connection between the shaft and head. The femoral neck is the weakest part of the femur. For this reason, fractures are most likely to occur when strong forces act on the bones.

In USA, more than 130,000 femoral neck fractures occur every year. The frequency increases from the age of 60. The fracture of the femur is the most common cause of hospitalization in people over 65 years of age (1). Over 80s are particularly often affected. In the past, such a rupture often led to the need for care. Today surgical methods, therapy and rehabilitation measures have been improved so that a return to everyday life is usually possible.

Femoral neck fracture: causes

The femoral neck breaks relatively easily, especially in older people. The reason is the decrease in bone density in old age. The bone becomes brittle and can break on the hip even with slight falls. Seniors can stumble in everyday activities and suffer a broken femoral neck. Also dizziness, a brief loss of consciousness or coordination problems due to alcohol and medication can cause a fall.

In rare cases, certain types of cancer attack the bone substance and can cause the femoral neck to break even under low loads. But a broken femoral neck also occurs in healthy, young people. Here the bones are more elastic and stable. The force must be significantly greater, such as in an accident.

Femoral neck fracture: appearance/symptoms

A broken femur neck causes severe pain. In some cases, bruises and swelling in the hip area are also visible. Fallen people can often no longer get up. The pain mainly occurs in the groin and hip area and increases when the leg is moved by an examining doctor. It is no longer possible to move the leg on your own. If the bone has shifted at the breaking point, the leg can be twisted or appear shorter.

There are fractures of the femur, in which those affected do not feel extreme pain and can sometimes even walk independently. This can happen if the bone breaks smoothly and does not shift. However, these cases are the exception.

Femoral neck fracture: examinations & diagnosis

If you suspect a broken femoral neck after a fall or accident, the doctor first clarifies the external circumstances: How was the accident? Where do pains occur and how severe are they? Are there other diseases (cardiovascular problems, diabetes, osteoporosis or others)? The doctor then examines the location of the injury closely and looks at mobility, skin bruises and blood flow. It is also being clarified whether the accident has caused other injuries in other places.

Imaging methods provide reliable evidence. The doctor can see on the X-ray whether a fracture actually exists. He can also assess where the fault line is and whether the bone ends have shifted against each other. To plan the operation, even more precise procedures can be used that map the bone down to the finest detail. These include computed tomography (CT) and magnetic resonance imaging (MRI).

Femoral neck fracture: therapy & rehab

If the suspicion of a fracture of the femoral neck has been confirmed, then surgery has to be carried out in most of the cases. Afterwards, a rehab helps patients to put more strain on their legs soon.

Therapy for fractured femoral neck

In rare cases, the bone ends lie so stable and exactly on top of one another that a splint, pain reliever and physiotherapy are sufficient for treatment. In most femoral neck fractures, however, the bone ends are shifted. In this case, surgery is always necessary. The earlier the operation, the better the healing. Surgery within 24 hours of the accident is ideal (2).

Different surgical methods can be used. In an operation that preserves the hip head, the fracture is joined with special screws or plates. In a femoral head replacement surgery, the femoral head or the entire hip joint is replaced by a prosthesis. Joint replacement is usually more sensible for people over the age of 65, since blood flow and healing capacity of the bones are lower in the elderly. In these cases, healing with a prosthesis is significantly faster.

Rehabilitation

An artificial joint can be stressed again soon after the operation. If the patient’s own joint head has been preserved, longer follow-up care in the hospital is necessary. In any case, it is important that patients become mobile again as soon as possible after the operation. Otherwise lying too long leads to the loss of muscle mass and worsens the prognosis. Rehabilitation helps those affected to recover and quickly return to everyday life.

Physiotherapy/Physiotherapy

The rehab follows directly after the operation. The first exercises should begin shortly afterwards (2). Physiotherapy gradually moves and stresses the leg. The muscles are built up. If you are afraid of a new fall after a fracture of the femur, trained physiotherapists in rehabilitation clinics will respond to it and build up safety with you as part of a gait training session when walking, climbing stairs and performing household chores.

Specialized clinics for your needs

Find a rehabilitation clinic that is tailored to your needs. Geriatric clinics offer many advantages for seniors. There, the specialists are optimally equipped for all comorbidities, osteoporosis, dementia and age-related risks. The clinic is also age-appropriate with short distances, barrier-free access and intensive patient care. If the hip joint is completely replaced (total hip replacement, hip TEP), then a specialized ” hip rehab ” is suitable .

Intensive care and advice

In the rehabilitation clinic, patients are cared for comprehensively by specialists and trained specialists. The healing of the femoral neck fracture is regularly checked by a doctor. Fall causes such as cardiovascular diseases or neurological diseases are treated to prevent another fall. Nutritionists help you choose a suitable diet (e.g. high in calcium). If necessary, patients receive training, help and instructions on how to avoid falls and how to move safely in everyday life (bathroom, toilet, etc.).

Opportunities and benefits of rehab

After a broken femoral neck, the goal of rehab is to get the patient back on the move as soon as possible. Lying too long breaks down muscles, can lead to infections (pneumonia) and worsens the prospects of healing. In rehab, under medical supervision and expert guidance, you can learn how to strain your leg again. Information on how to avoid falls helps to overcome fears and to move safely in everyday life. Studies show that interdisciplinary follow-up care is crucial for quick and complete healing (3).

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