What to do if the femoral head is broken
| The femoral head is one of the most important bones in the human body, which is related to people's normal walking ability. Therefore, when the femoral head is fractured or broken, it will directly affect people's lives and work. Many people don’t know how to deal with a femoral head fracture or when exercising, which can easily lead to a more serious fracture, so pay attention to emergency measures. What should I do if the femur is broken? 1. Non-surgical treatment: For patients with fractures not accompanied by hip dislocation, if there is no obvious displacement or compression of the fracture fragments, non-surgical treatment can be performed. After resting in bed for 3 weeks, the patient can get up with crutches and not bear weight on the injured limb. Giebel believes that long-term traction should be avoided, otherwise it is easy to cause ischemic necrosis of the articular cartilage and joint stiffness. Fractures accompanied by dislocation should be reduced immediately. During reduction, anesthesia should be sufficient to avoid the use of violence, and strive for a successful reduction in one time. If it fails for two consecutive times, surgery should be considered. After reduction, take an X-ray to understand the reduction situation, and do a CT scan to clarify the position, size and displacement of the fracture fragments. 2. Surgical treatment : When the fracture fragments are obviously collapsed, displaced, embedded in the joint space, accompanied by dislocation and manual reduction fails or there is nerve damage, open reduction should be performed immediately. Select the anterolateral or posterolateral approach according to the location of the fracture fragment, expose the hip joint and dislocate the femoral head from the acetabulum. If the bone fragment is small, it can be removed. If the fracture fragment is large, it should be repositioned and fixed with screws. When the fracture fragment is large and thick, a cancellous bone traction screw can be inserted retrogradely through the extra-articular part of the femoral head. If there is difficulty, only the absorbable screw can be drilled antegradely, and the screw head should be lower than the cartilage surface. If the fracture part collapses, it should be pried up and padded with autologous cancellous bone. If the collapse range exceeds half of the weight-bearing surface of the joint, and the comminuted fracture is difficult to fix internally or is combined with a femoral neck fracture, joint replacement should be considered. After the operation, it should be repeatedly flushed before suturing to avoid leaving cartilage or bone fragments. Negative pressure drainage should be left in place for 24 to 48 hours. 3. Femoral head fractures are mostly caused by conduction , shearing and compression violence. Fractures occur at sites far away from the site of violent action, rather than at sites where the violence directly affects the body. Fractures are caused by force through conduction, leverage, or rotation. |
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