Definition
A femoral neck fracture is a fracture of the bone in the area of the femoral neck. The femoral neck anatomically forms the connecting piece between the head of the femur and the femoral shaft. Depending on its location, a distinction is made between different types of femoral neck fracture.
If the fracture lies within the joint capsule, it is called a medial femoral neck fracture. If the fracture lies outside the capsule, the fracture is classified as a lateral femoral neck fracture. This classification plays an important role in the treatment of the femoral neck fracture.
The femoral neck fracture is one of the most common surgical indications in trauma surgery and primarily affects older women. The most common accident mechanism is a fall on the hip. Elderly people in particular have problems walking safely.
On the one hand, this is due to age-related limitations in gait safety, on the other hand, a variety of common diseases in old age, such as high blood pressure or osteoporosis, can make walking unsafe. In addition, the bone itself is not as fracture-resistant in older people compared to young people. The osteoporosis in older women already mentioned is an important cause of this. However, malignant diseases (cancer) can also reduce bone density and thus increase the risk of fracture. Bone densitometry can be used to assess the severity of osteoporosis and thus the risk of fracture.
Frequency and gender distribution
The femoral neck fracture is a relatively common fracture that occurs mainly in older women. The risk of suffering a femoral neck fracture once in a lifetime is about 10% for men and about 20% for women.
Cause
By far the most common cause of a femoral neck fracture is a fall on the hip. Since falls mainly affect the elderly, the femoral neck fracture is often found in older people. In addition, bone density is reduced, especially in older women with osteoporosis.
As a result, the bone is no longer as stable and fractures occur more easily. Other concomitant diseases such as dizziness, high blood pressure or heart problems can severely impair gait safety and thus lead to falls. For this reason, fractures of the femoral neck are often found in old people’s homes and hospitals, i.e. where there are many old and often sick people.
Especially when elderly people try to get up alone after long periods of bed rest, for example to go to the toilet, the overestimation of their own ability to walk can lead to falls and fractures. In addition, older people are also more often affected by malignant cancer. Just like osteoporosis, bone tumors can make the bone brittle. Primary bone tumors, i.e. tumors that develop directly from bone tissue, are far less common than bone metastases (“tumor offshoots” of a cancer of another organ in the body), as are frequently observed in breast cancer, prostate cancer, and lung cancer. Thus, a spontaneous bone fracture without the application of great force can be an indication of cancer.
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