Diseases of the thigh

The fracture of the femoral neck (also called just femoral neck fracture) is a very common fracture. It mainly affects postmenopausal women and patients suffering from osteoporosis. Anatomically, the femoral neck fracture is divided into a medial (inside the joint capsule) and a lateral (outside the joint capsule) fracture.

Furthermore, the femoral neck fracture can be further subdivided by specific classifications (Garden and Pauwels Classification) including the fracture line and the degree of dislocation of the fracture fragments. Whether or not surgical treatment of the femoral neck fracture is performed depends on these criteria. Medial femoral neck fractures are usually caused by adduction trauma and are unstable.

Surgical treatment is indicated in this case. Lateral (outside the capsule) fractures of the femoral neck, which are usually stable and are caused by abduction trauma, can usually be treated conservatively. In addition to the above criteria, the age of the patient is also decisive for the choice of surgical procedure.

In young patients, a femoral head preserving screw connection is usually preferred. Due to the arterial blood supply, this should be done within the first six hours after fracture. Older patients are preferably treated endoprosthesis-supported.

The reasons for this are the usually reduced bone density in older patients and the desire to achieve early mobilization. Possible complications of femoral neck fractures must be taken into account. As with all fractures, these are possible bleeding, thrombosis or embolism.

A lack of blood supply can also lead to necrosis of the femoral head. A contusion of the femur is caused by a bruise (contusion) of the muscular tissue due to various causes. In addition to the musculature, the skin, fat and connective tissue are also bruised.

Causes can be falls, traumatic compressions, the impact of objects, etc. Especially in the case of thigh contusions, one speaks of the typical “horse kiss“. In the case of a harmless contusion, there is initially no bleeding into the tissue or swelling.

However, in the case of severe contusions, these can occur. Due to the severe pain, the movement of the thigh is very limited. Therefore, the PECH rule (pause, ice, compression, elevation) is also applied here.

To treat the pain of a thigh bruise, ointments containing arnica, bepanthene or paracetamol can be applied by oral administration. Strain of the thigh is an acute clinical picture, in which the overstretching of the muscles of the thigh leads to stabbing pain. The strain of the thigh is one of the typical sports injuries.

Basically, it is a less serious injury than a torn muscle fiber. The pathophysiological basis of thigh strain is the destruction of the microstructure of the muscle (sarcomere). It is important to know that strains of the musculature occur in a few cases without prior impairment of the muscle structure.

If, for example, there is a specific joint malposition or a pre-existing muscular damage, strain is favored. However, permanent overloading of the musculature greatly increases the probability of a pulled muscle. Sports with typical jerky dynamic movements, combined with many changes of direction, are typical for the occurrence of thigh strains (e.g. soccer, tennis, basketball, squash, badminton).The continuous intake of anabolic hormones or steroids also promotes the occurrence of muscle strain, as the muscles grow beyond their physiological size.

If a thigh strain is treated properly, it is an injury with a good healing tendency. Important rules are immediate protection of the affected muscles combined with elevation, cooling with ice and compression with a pressure bandage. (PECH rules: rest, ice, compression, high positioning).