Femoral neck fracture (proximal femoral fracture)

Overview

Fractures of the femoral neck are common in older people in particular. They are mostly caused by falling, but can also occur spontaneously. We distinguish between femoral neck fractures and trochanteric fractures. An immediate inability to walk, severe pain and abnormal leg position are typical symptoms. The risk of falling should be minimised by introducing preventive measures.

Symptoms

• Usually, immediate inability to walk
  • However, still being able to walk doesn’t exclude a fracture
• Pain, often located in the groin
• Abnormal position of the injured leg (usually shortened and turned outwards)
• Contusion marks, swelling and bruising in the hip region

Consequences and complications:

• Confinement to bed, risk of bedsores
• Thrombosis
• Lung embolism, pneumonia
• Protracted healing process
• Loss of independence

Causes and treatment

Causes

• Trauma caused by a fall or collision/impact
• Caused by
  • Reduced mobility and reaction time
  • Vision problems
  • Pre-existing disorders (cardiovascular)
  • Side effects of medication
  • For younger people: Traffic and sport accidents
• Spontaneous fracture
  • Osteoporosis
  • Bone tumours/metastases

Further treatment by your doctor / in hospital

Possible tests

• Physical examination
• X-ray
• CT scan (computed tomography), if necessary

Possible therapies

• Operation
  • Preferred method
  • Urgent procedure
  • Hip replacement (primarily for older people)
  • Screws, plates and intramedullary nails
• Conservative therapy (i.e. no operation)
  • Patients for whom the operation risk is too high
• Medication
  • Blood-thinning drugs (to reduce the risk of thrombosis)
  • Painkillers

What can I do myself?

• Install an alert system for people living alone and people who are in danger of falling
• Prevent falls
  • Controlled walking, suitable shoes
  • Careful with door frames, the edges of carpets and slippery floors
  • Safety modifications at home: good lighting, eliminate structural risk factors, non-slip floors, handrails
  • Visual aids
• Use walking aids (walking stick, Zimmer frame, etc.)
• Prevent or combat osteoporosis
  • Take calcium supplements after menopause: at least 1.5g/day
• Reduce overweight
• Consult the preventive care recommendations for a list of sensible preventive examinations.

Get a personal Preventive Care Recommendation now.

When to see a doctor?

• Wrong movement, fall, impact causing the following problems
  • Pain in the hip/groin region
  • Inability to walk
  • Abnormal position of the leg
  • Sensory disturbances in the leg
• Geriatric assessment
  • Evaluation of the risk of falling
  • Preventive measures
• For vision problems: treatment by an eye doctor

Synonyms

femoral neck fracture, fracture of the femoral neck, hip fracture, trochanteric fractures, proximal femoral fracture, pertrochanteric fracture, intertrochanteric fracture