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Femoral Neck Fracture

The hip is a ball-and-socket joint made up of the head of the thigh bone or femur that acts as the ball and fits into the rounded socket of the hip bone or acetabulum. The neck of the femur is the region just below the ball of the hip joint.

Fractures to the femoral neck can completely or partially disconnect the femoral head from the rest of the femur. Femoral neck fractures may be either displaced, where the bone is moved out of its original position, or non-displaced, where there is no instability of the bone. These fractures may disrupt the blood supply to the fractured portion of the bone.

Causes

Femoral neck fractures can occur with:

  • Minor fall or twisting of the hip in the elderly
  • Osteoporosis or degradation of bone
  • Stress on the femoral neck
  • Strenuous activity or high-impact trauma to the hip in young people

Signs and Symptoms

The symptoms of femoral neck fracture include:

  • Radiating pain to the knee
  • Inability to bear weight
  • Shortening or sideways rotation of the affected leg
  • Increased pain in the hip during rotation of leg
  • Swelling on the side of the hip

Diagnosis

Your doctor may order an X-ray to diagnose femoral neck fracture. The doctor may also perform other imaging tests such as magnetic resonance imaging (MRI), and computer tomography (CT) scan to detect the fracture.

Radiographic image of a broken Shenton's curve, which shows the relationship of the femoral head to the acetabulum, indicates a femoral neck fracture.

Treatment

Conservative therapeutic approaches for uncomplicated fractures include bed rest for a few days. You may be slowly introduced to a physical therapy rehabilitation program after 2 or 3 days. Your doctor may prescribe medications to prevent clotting, pain and infection.

Surgery is a necessity in most cases of femoral neck fractures. The surgical procedures are performed under general or spinal anesthesia. Hip pinning is recommended if your facture is minimally displaced and you have sufficient bone density. Your surgeon will make a small incision on the outside of your thigh and pass several screws to stabilize the broken bones.

Hip hemiarthroplasty or partial hip replacement is suggested if you have a displaced fracture. Your surgeon will make an incision over the outside of the hip, remove the femoral head and replace it with a metal implant. 

Total hip replacement is recommended if you have had arthritis of the hip prior to the fracture. Your surgeon will replace the femoral head as well as the socket of the hip joint with artificial metal implants.