Symptoms
A fracture of the femoral neck, which often occurs in the context of a fall, can manifest itself through a variety of symptoms. In the foreground is certainly a severe pain in the thigh of the affected side. This occurs mainly under stress, many patients complain of pain even at rest.
The pain does not have to be strictly localized to the hip region. Depending on the extent of the injury, the pain can also radiate into the back or leg. Hematomas (bruises) are visible from the outside of the patient’s body, which are caused by the fall on the hip.
Depending on the severity of the fall, such a hematoma can take on large dimensions and may even require surgical treatment. In addition, the fracture of the femoral neck often leads to a shortening and malpositioning of the affected leg. In this case, the leg is rotated outwards in the hip and often only returns to its original position with severe pain. In very few cases can patients still put weight on the leg after a femoral neck fracture so that they cannot get up again on their own. In this case, they are dependent on help from outside or notify the emergency doctor directly.
Diagnosis
The first step in the diagnosis of a femoral neck fracture is an anamnesis by the doctor, i.e. a discussion about the cause of the fracture and the existing symptoms.The doctor is particularly interested in how exactly the femoral neck fracture occurred, i.e. whether a fall occurred or whether the patient suffers from certain pre-existing conditions such as osteoporosis. In most cases, the physician can make the suspected diagnosis of a femoral neck fracture immediately after taking the patient’s medical history.
The next step in the process of making a reliable diagnosis is imaging. X-ray of the hip is the method of choice here. In complicated cases such as polytraumas, computed tomography can also be performed initially.
In the X-ray, the physician then either sees a fracture gap directly at the femoral neck or an anatomically incorrect position of the joint. This can occur when the individual bone fragments move against each other in the event of a fracture. If a femoral neck fracture is now diagnosed, an operation must almost always follow for treatment.
If the fracture lines are not clear on X-ray or if the fracture is very severe, a computer tomogram can be taken in addition to the X-ray image. With the help of this additional imaging, the operation can be better planned. In addition, concomitant injuries, such as further fractures of the femur, can be detected.
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