General measures Review of permanent medication due topossible effect on existing disease. General therapy measures – pre-stationary Proceed expeditiously to surgical therapy – surgery within six to 24 hours reduces the risk of femoral head necrosis Transport/rescue under gentle longitudinal traction on the fractured leg. Position on a vacuum mattress/foam splint, etc. Sacrum (sacrum), coccyx … Femoral Neck Fracture: Therapy
Therapy goals Pain relief. Prevention of thrombosis (vascular disease in which a blood clot (thrombus) forms in a blood vessel). Avoidance of complications (eg, infections). Therapy recommendations Analgesia (pain relief) according to WHO staging scheme. Non-opioid analgesic(acetaminophen, first-line agent). Low-potency opioid analgesic (e.g., tramadol) + non-opioid analgesic. High-potency opioid analgesic (eg, morphine) + non-opioid analgesic. … Femoral Neck Fracture: Drug Therapy
Obligatory medical device diagnostics. Conventional radiographs: Deep pelvic overview Proximalfemur axial If necessary, X-ray control examination (CT, MRI) 3-4 days after the accident in the initial absence of fracture evidence. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic … Femoral Neck Fracture: Diagnostic Tests
Surgical therapy represents the first-line treatment for femoral neck fracture: Osteosynthesis – surgical procedure to treat fractures (broken bones) and other bone injuries (e.g., epiphysiolysis) to quickly restore full function. This is done by implants (by means of insertion of force carriers such as screws or plates). Hip endoprosthesis (hip TEP; total endoprosthesis of the … Femoral Neck Fracture: Surgical Therapy
To prevent femoral neck fracture (femoral neck fracture), attention must be paid to reducing individual risk factors. Bone-related factors that lead to an increased likelihood of fracture Behavioral risk factors Diet Malnutrition Micronutrient deficiency (vital substances) – vitamin D, calcium. Consumption of stimulants Alcohol (woman: > 40 g/day; man: > 60 g/day). Tobacco (smoking) Physical … Femoral Neck Fracture: Prevention
The following symptoms and complaints may indicate a femoral neck fracture (femoral neck fracture): Leading symptoms Motion-dependent pain in the hip joint/groin. Radiation of pain into the knee possible Shortened leg with external rotation (external rotation) – especially with dislocation (displacement or twisting of bones). Inability to lift the injured leg stretched. Walking / standing … Femoral Neck Fracture: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Femoral neck fracture can result from a variety of injury mechanisms. Etiology (causes) Injuries, poisonings, and other consequences of external causes (S00-T98). Fall from standing or sitting height Stumbling e.g. over the carpet Chronic overloading of the bone (in osteoporosis) and varus position (“bent outward”). High-rasan trauma with axial compression of … Femoral Neck Fracture: Causes
Medical history (history of illness) is an important component in the diagnosis of femoral neck fracture (femoral neck fracture). Family history Are there any conditions in your family that are common? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). Are you in pain? Where is the pain localized? Was there a fall event? … Femoral Neck Fracture: Medical History
Musculoskeletal system and connective tissue (M00-M99). Activated coxarthrosis (hip osteoarthritis). Bursitis ileopectinea – inflammation of the bursa between the hip joint capsule and the iliopsoas muscle. Coxitis (inflammation of the hip) Insertion tendopathy – irritation of the tendon (tendon attachments). Pathological fracture (spontaneous fracture) – bone fracture without force on a pathologically changed bone. Injuries, … Femoral Neck Fracture: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by a femoral neck fracture (femoral neck fracture): Respiratory system (J00-J99) Pneumonia (pneumonia; occurs especially in geriatric patients). 1.2% of patients already suffered from pneumonia at the time of surgery; this was associated with an increased rate of complications (relative risk … Femoral Neck Fracture: Complications
According to the ICD-10, the following forms can be distinguished: Intracapsular fracture (S72.01) – fracture line located in the capsule. Fracture in the region of the epiphysis (S72.02) – fracture line located in the joint end with bone core Subcapital fracture (S72.03) – fracture line located below the articular head. Mediocervical fracture (S72.04) – fracture … Femoral Neck Fracture: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing): [Walking/standing is not possible.] Soft tissue damage: Bruise marks and hematoma (bruise) usually posterolateral (Lat.: posterior, posterius – posterior; latus – side, flank) to the greater trochanter (large rolling … Femoral Neck Fracture: Examination
