What to do if the femoral head is fractured?

If the femoral head is fractured, you must take timely measures to deal with it and fix the fracture site. There are many ways of fixation, such as closed reduction and internal fixation, single nail fixation, or sliding nail plate fixation, which can be solved according to the situation.

1. Traction reduction

Use tibial tuberosity bone traction (1/7 body weight) to reduce the fracture within 1 to 2 days. The direction of traction is generally 30° of flexion and abduction. If there is a backward angle, abduction traction can be performed with the hip extended. At the same time, a full-body examination should be performed to rule out serious concomitant diseases and injuries. Internal fixation should be performed as soon as possible after bedside radiography confirms that the fracture has been reduced.

2. Closed reduction and internal fixation

For patients whose fractures have been reduced by traction before surgery, the injured limb can be kept in an abducted and internally rotated position using an orthopedic traction operating table after anesthesia, and internal fixation can be performed under the guidance of fluoroscopy or radiography. Forceful reduction manipulation during surgery should be avoided to prevent further damage to the blood supply to the femoral head.

3 single nail fixation :

Represented by the three-wing nail. Three-wing nail internal fixation was once a common method for treating femoral neck fractures. However, it is now rarely used because of the large bone loss during placement and the difficulty of single-nail fixation in simultaneously counteracting the compressive stress on the inner side of the femoral neck and the tensile stress on the outer side. Some people use a single thicker compression screw for internal fixation. The threaded part of the screw must remain entirely in the proximal fracture segment and cannot cross the fracture line, otherwise the compression effect will be lost.

4 Sliding nail plate fixing:

It consists of fixing nails and side steel plates with sleeves. The advantage is that it helps maintain close contact between the fracture ends and is more commonly used in intertrochanteric fractures.