The femoral neck fracture – cause and consequences

- Cold weather and icy roads increase the risk of injury from incidental slipping this season. Young people will often get away with a few painful bruises, but for people of older age, falling can become a serious issue. The upper arm and upper leg bones are most likely to be affected in such cases. A femoral neck fracture is one of the most critical injuries of the elderly – a medical emergency, as the longer the fracture remains untreated, the higher the risk is of complications, potentially causing death.

Falling at seniority

From the age of 30 onwards, our bone mass continuously decreases. At an older age, osteoporosis, the pathological decrease of bone density, can also set in. Many postmenopausal women are affected by this. Through the physiological or osteoporotic decrease of bone density, the entire skeletal stability diminishes. A loss of muscular strength and sensory perception, in combination with common issues such as a disturbance of one’s equilibrium, can often cause falls in daily life. With a decreased bone capacity, falling from standing or sitting height can already lead to bone fractures.

Risk factors and how to avoid them

The main risk factors for falling and fracturing bones are old age and osteoporosis. Women who have experienced menopause are four times more often affected by osteoporosis than men. Their decreased estrogen levels disturb the balance between bone buildup and decomposition. The bone decomposition is stronger and so the loss of bone density advances continuously.

Malnutrition, insufficient vitamin D or physical activity, smoking and taking cortisol can have a negative effect on bone density. People above the age of 70, or with the above mentioned risk factors, are highly recommended to have a consultation with their physician. A decrease in body size is also a strong indicator of osteoporosis. Regular examination, including measuring the body height, is therefore essential. The radio transmittable ultrasound measuring station
seca 287 can quickly and precisely determine such data.

A strong decrease of bone mass, be it through too little movement or malnutrition, can also increase the risk of falling and fracturing one’s bones. By using the seca mBCA, the body composition can be accurately measured, making it possible to detect muscular atrophy or malnutrition early on. Factors that increase the risk of falling should be avoided in any case. It is recommended to wear sturdy shoes and avoid tripping hazards. It can also help to strengthen the muscles through systematically targeted functional kinetics. Patients at risk can also decrease the risk of femoral neck fractures by up to 70%, by wearing hip protection.

After having fallen

If people of older age fall, it is important to react quickly. Patients with a fresh femoral neck fracture cannot, and should not, stand up on their own. Often the affected leg will show signs of pain and movement restrictions. The leg will also often not be in its natural physical position, but could be shortened or rotated towards the outside. In this case, emergency transport to the nearest hospital is of highest urgency. If possible, the operative care should take place within 24 hours of the accident. The earlier the surgical intervention, the better the prognosis.

Depending on the patient’s profile and the existing risk factors, various operational measures can be taken. With younger patients, the doctors will try to conserve the femoral head, while with older patients a hip joint prosthesis is often chosen. Many hospitals offer this operation as a standard procedure. After the operation, patients are mobilized as quickly as possible, to avoid stiffening of the joints and further complications. Patients can therefore already sit out of their bed only one day after the procedure. With the help of physiotherapy, they will be trained to try and take their first steps early on. Adequate therapy and follow-up care reduces the risk of complications and ensures the patient’s independence, which enables a quick recovery back into daily life.

Image 1 © “JanMika” / Fotolia.com

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