Fracture Neck Of Femur


Causes and Types

Osteoporosis causes thinning or weakening of the bone due to loss of bone mass. This condition affects the elderly population of the society, particularly women. With thinner, weaker bones, people with osteoporosis are at much greater risk for developing a hip fracture from even a trivial fall.

In the younger patients the cause of this fracture is high energy impact injuries such as vehicle accidents.

Spontaneous fracture without a fall may occur if the area of bone is involved with cancer or infection and this type of fracture is called a pathologic fracture.

Hip joint fractures comprises of four subtypes. The differences between these subtypes are significant as each is treated differently.

But to understand these subtypes it is important to know the anatomy of the femur. The upper end of the femur (thigh bone) is made up of the head, the neck and two trochanters the greater and lesser tronchanter located like a ridge on the upper end of the long bone.

1. Femoral head fracture involving the femoral head is usually the result of high impact trauma, such as motor accidents, and often results in the dislocation of the hip joint.

2. Femoral neck fracture (also called Neck of Femur (intracapsular or subcapital fracture) denotes a fracture in the neck region between the femoral head and the greater (or) upper trochanter. The neck is narrow between the head and the shaft of the bone and at an angle making it the weaker part of the bone that is prone to fracture. Fracture of the neck disrupts the blood supply to the head of the femur. It is also referred to as trans-cervical (cervical for neck) fracture. The fracture may or may not displace the bone involved.

Hip fracture or Broken hip or Fracture Neck of Femur all mean the same type of fracture.

The more vertical the fractured bone appears on the X- ray films the poorer is the prognosis. This disrupts the blood supply to the head of the bone which comes in a retrograde fashion (i.e) from the region of the neck upwards. This leads to loss of blood supply which in turn results in necrosis or cell death this is referred as avascular necrosis of the head of the femur.

Garden has classified this fracture into four sub-types:-

Type 1 is a stable fracture. Here there is a minor crack in the neck of the bone

Type 2 is complete crack in the neck of the femur but without bone displacement

Type 3 is displaced fracture but with the fragments retaining contact between them, there may also be rotation and/ or angulation of the fragments.

Type 4 is completely displacement with no contact between the fracture fragments. In this type the chances of blood supply disruption is more likely.

3. Intertrochanteric fracture is the most common type of hip fracture and refers to a fracture line between the greater and lesser trochanter. The prognosis for this type of fracture is fairly good, especially in a healthy patient.

4. Subtrochanteric fracture occurs in the shaft (body) of the femur, below the lesser trochanter.

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My dad is 81 years old and suffered fracture of femoral neck, operated and metal rod (all along the femur) and screws were used to stabilise and treatment. After 5 months there is no pain or discomfort. But what should be done so that he starts walking again. He is constantly cared by a nurse and legs receive daily massage and they seem to have improved along with strengthening excercises. But my dad is reluctant to try more efforts and try walking even with 'walker' support and us around him to help.
Does he need psychological analysis and help to overcome his reluctance?
rajur  Tuesday, June 18, 2013
i am 39 years old and i have a tumor in neck of femur, was told to be carefull as it could fracture but they are going to monitor every 6 months, i am in alot of pain n often wake crying cause of it what are my options?doctor said if they operate i may never walk again plz help cause i can not keep living on pain killers
chrissy73  Sunday, March 25, 2012
Hi am sravani studying 2nd dad was met with an accident 3months back.he had poliomyelitis.his neck of the femur was fractured after that he was operated but it was not success.dey kept screws over there but they came he is again going for i request u 2 suggest for my dad's operation which could make him normal.thanking mail id is
sravani  Monday, November 1, 2010
This article requires some more detailing.
The animated sketch showing the various sites of fracture is very helpful
Bhavya  Wednesday, August 25, 2010
Fracture Neck Of Femur - Symptoms and Diagnosis
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