What are the treatments for femoral neck fractures?

Femoral neck fracture is actually a relatively common fracture site, especially for young and middle-aged people and the elderly. The most common treatment method is surgery or reduction and internal fixation.

1. Causes

There are two basic factors that cause fractures in the elderly: osteoporosis, which reduces bone strength, and the dense distribution of nutrient vascular holes in the upper area of ​​the femoral neck, both of which can weaken the biomechanical structure of the femoral neck and make the femoral neck fragile. In addition, due to the degeneration and slow reaction of the hip muscles in the elderly, they cannot effectively offset the harmful stress on the hip. In addition, the hip is subjected to greater stress (2 to 6 times body weight) and the local stress is complex and changeable. Therefore, fractures can occur without much violence, such as slipping on flat ground, falling off the bed, or sudden twisting of the lower limbs, or even without obvious trauma. Femoral neck fractures in young and middle-aged people are often caused by serious injuries such as car accidents or falls from heights. Fractures that occur gradually due to excessive and prolonged weight-bearing work or walking are called fatigue fractures.

2. Surgical treatment

The best treatment for femoral neck fracture is manual reduction and internal fixation. As long as satisfactory reduction is achieved, most internal fixation methods can achieve a healing rate of 80% to 90%. Only 5% to 10% of non-union cases require surgical treatment in the future. Even if femoral head necrosis occurs, only 1/3 of cases require surgical treatment. Therefore, the treatment principles of femoral neck fractures should be: early atraumatic reduction, reasonable multiple nail fixation, and early rehabilitation. Artificial joint replacement is only suitable for patients over 65 years old with Garden III or IV type fractures who can tolerate surgical anesthesia and trauma.

3. Reduction and internal fixation

The results of reduction and internal fixation methods are mainly related to whether the reduction is correct, whether the fixation is correct, and the postoperative recovery situation, in addition to the degree of fracture injury, such as the degree of displacement, the degree of comminution, and whether the blood supply is damaged.

4. Artificial prosthesis replacement.