This pathological anatomy violation of the femur occurs in people of all ages, but the older the patient, the lower the probability of successful recovery.Doctors attributed the problem to the category of particularly difficult.hip fracture is extremely difficult to give in to conservative treatment.In most cases, doctors have to resort to immediate surgery, but it does not always ensure a favorable outcome.Having a basic understanding of the causes and characteristics of this disease, you will be able to avoid disappointing consequences.
Causes of hip fracture
According to statistics, more than others are at risk of getting this dangerous injury the fairer sex.It sounds scary, but every woman is able to protect themselves from the problem, or at least, reduce to zero the probability of its occurrence.Rehabilitation after hip fracture may last for years, so experts recommend to monitor their condition, in order to prevent a critical deterioration.To do this, you need to know exactly what factors h
In old age
Over the years, the musculoskeletal system of man weakens.Patients older faced with this problem in the background of the deterioration of bone tissue.In older people often develop osteoporosis - a disease terrible exchange, reflected an increase in bone fragility.This violation entails serious injuries, including and femoral neck injury.The second common factor contributing to the emergence of such pathologies - a weakness of the muscles and tendons.The main root of all these problems is a sedentary lifestyle.
At a young age
Patients aged 40-45 years old femoral neck injuries are characterized by high-energy trauma.Such phenomena can often occur in road traffic accidents, a fall from a great height, in the preparation of high-power strikes at industrial enterprises.Chronic diseases associated with a sedentary lifestyle (such as osteoporosis, and physical inactivity) rarely lead to femoral neck injury in young and middle age.
Types There are several types of hip injury, and each of them is characterized by a number of features that define the procedure for the appointment of therapeutic measures.Modern medicine is well studied these species and identified numerous dependencies between fracture form and the further course of the disease.Along with this treatment, a set of programs, each of which is used in strict accordance with situations.After reading the following sections, you will get an overview of the classification of femoral neck injury mechanisms.
relatively articular fastening
neck injuries femur divided into several categories.By location fault lines distinguish two groups of hip injuries:
- Intra-articular fractures (medial).As a rule, occur in the elderly.The specialists note that women are faced with this problem in two times more often than men.A characteristic feature of intra-articular fracture - no wedging open fragments medially.the fracture line is located at the place of the neck with the head of the hip joints and may extend obliquely or transversely.
- fractures Lateral (side).A rare form of injury, which is found in 15-20% of cases.It is characterized by the fact that the fracture line runs exactly along the literal border.It intersects the base of the femoral neck, but does not reach the area skewers.As a rule, these fractures displacement is not observed.
location From the strength and direction of impact entailing neck injury, the location of the fracture line depends.Evaluating all cases of injuries of the femur on this criterion, we can identify three main categories:
- transcervical - crossing the femoral neck;injury of moderate severity with a good possibility of successful conservative treatment.
- subcapital - located directly at the head of the femur.The worst type of fracture.Its danger lies in the fact that in case of violation of bone tissue anatomy and blood flow to the head deteriorates.When subcapital fracture without surgery bone tissue recovery almost impossible.
- Bazistservikalny - at the base of the femoral neck.The most favorable of all possible options.the fracture line is in the beginning of the femoral neck, and forecasts splicing usually positive.
Types of fractures with displacement
top of that, the medicine commonly used classification of femoral injuries Garden on the system, taking into account the displacement of torn tissue.According to her, all the hip injuries are divided into three groups:
- varus.Head moves inward and downward.The angle between the base and the neck of the femur decreases.
- valgus.Shifting heads directed upwards and outwards.Marked increase in the angle between the neck and the base of the bone.
- impacted.When one of these fractures of the thigh bone fragment is hammering in another.Typically, these injuries are both valgus.
Key signs and symptoms
hip fracture manifests itself in many different ways.People faced with this problem are the following signs / symptoms:
- injuries / bruises / bruising in the area of the pelvis;
- bony protrusions that probed in the upper third of the outer surface of the femur;
- sharp unbearable pain in the area of bone damage;
- pain in the groin or pelvis when tapped on the heel;
- slight shortening of the legs that occurs due to the displacement of bone fragments;
- «syndrome stuck heel" when a person is not able to independently raise the heel, while in the supine position;
- crunch of bone damage in the area.
When the patient turns to the experts with a suspected injury to the femoral neck, the doctors analyze the current situation, taking into account a number of factors.When setting the diagnosis takes into account the following:
- patient complaints.The patient can observe the impossibility of the axial load on the injured limb, pain in the pelvis or groin.Unpleasant sensations in the pressing state of rest.
- History.If the patient reports that there has been a fall from a great height or damage to a heavy object in an accident, for the doctors it will be one of the determining factors.
- clinical picture.A person with an injured neck of the femur is marked violation of legs and difficulty axis active internal rotation.When the load on the hip axis of the patient feels a sharp unbearable pain in the fracture area.
- These X-ray examination.The image of the femur can accurately determine the presence of a fracture.The line of fracture detected on X-rays, is the ultimate objective basis to confirm the preliminary diagnosis, exposed on the basis of patient complaints, medical history and clinical presentation.
Methods of treatment of hip fractures
After setting an accurate diagnosis, doctors opt for treatment.The order of events is determined by prescribing the type of injury.In addition, considerable importance is the age of the patient.Whatever it was, all the methods of treatment of femoral fractures are divided into two categories: operational and conservative.More details about them are discussed in the following sections of this article.
Medicine tends to conservative treatment only in cases where there are factors that prohibit surgery.By the number of those can be attributed recent myocardial infarction, the third trimester of pregnancy, heart failure, etc.In addition, the reasons for the forced medical treatment may be of an organizational nature - for example, the lack of required medical equipment, painkillers or a competent surgeon.
essence of conservative treatment is as follows: the patient is immobilized (immobilize), bandage, conduct skeletal traction.In rare cases, the body is used to secure the plaster.Due to this, it manages to return the fragments in the correct position and secure splicing, but not always it happens safely.Conservative treatment is often accompanied by a mass of complications, so it can not be considered reliable.This method of dealing with the problem rather refers to folk.
Surgery - "gold" standard femoral trauma treatment today.Modern clinic widely used two effective methods of surgical treatment of this dangerous injury:
- Reposition, internal fixation (osteosynthesis).Select for patients under the age of 65 years.Surgeons correlate bone fragments, and then fix them significantly increasing the chances for a prosperous hip fusion.For fixing bones in a fixed position surgeons use special screws.They screwed across the fracture line.In this way, minimizing the risk of displacement of bone fragments.
- Endoprosthesis.Select for patients aged 65 years.The aim of the operation is the replacement of the neck and head bones.For the body is attached the artificial prosthesis femur.This method of treatment does not imply serious risks because not talking about the success of matching.
Following the success of the operation to eliminate the neck of the femur injury patient requires a long recovery for the full return of motor function of the damaged limb.In such cases, the assigned rehabilitation, which includes the following procedures, exercises and therapeutic measures:
- LFK.Under medical supervision the patient performs a set of simple exercises from a course of physiotherapy.Daily charging, light gymnastics, minor load on the leg - it all helps to improve blood flow, thereby accelerating the process of matching bones.
- constant care.The patient is protected from the forced physical exertion associated with self-catering.To him puts the nurse that provides regular meals and round the clock care.
- Massage.In the first weeks after the operation to remove the femoral neck injury it is necessary to do massage to the muscles atrophy.
- Drug prevention.Doctors prescribe vitamins, immunomodulators and natural remedies that support in the patient's normal balance of substances.Sometimes for the first few weeks after surgery is necessary to anesthetize the area of surgical suture.
- Fixing feet to improve the chances for successful splicing.To do this, the patient will have to wear a boot with derotation femoral neck fracture.
Possible complications and consequences
Because of this problem for more elderly people are suffering the consequences can be very, very heavy.In medical practice, often referred to following possible complications:
- necrosis of the femoral head as a result of the deterioration of blood circulation;
- formation of false joints in fragments;
- vein thrombosis;
- rejection of the prosthesis after surgery or loosening of the set design;
- arthritis, osteoarthritis, osteomyelitis.
Video on treatment of hip fracture in the elderly
The video below, there are photographs of distinct examples of fractures and schematics of surgical structures, used in operations.Watch this video to find out what to do with a broken femur and get a general idea of how modern medicine copes with this problem.