Femoral Neck Hip Fracture
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Databases searched: Pubmed, PEDro, eMedicine, Medscape
Keywords searched: hip fracture, incidence femoral neck fracture, osteoporotic hip fracture, treatment hip fractures …
Definition/Description[edit | edit source]
A hip fracture is a condition in which the proximal end of the femur, near the hip joint, is broken. Such a fracture is a serious injury that occurs mostly in elderly people over 65 years and complications can be life threatening. [1]
Clinically Relevant Anatomy[edit | edit source]
The hip joint is a ball and socket joint, formed by the head of the femur and the acetabulum of the pelvis. The convex head fits perfectly in the concave socket of the acetabulum forming a synovial joint. From an osteological viewpoint, the proximal end of the femur in four major parts, namely: femoral head, femoral neck, trochanter major and the minor trochanter. These parts are most often and most closely involved with hip fractures. The hip joint is a very sturdy joint, due to the tight fitting of the bones and the strong surrounding ligaments and muscles. [2]
Epidemiology /Etiology[edit | edit source]
Different events can form the basis of a hip fracture.
Young adult hip fractures are generally the result of high-energy trauma, and the larger peak seen in the elderly population is low-energy injuries, like a fall caused by gait and/or balance disorders.[1] Hip fractures are regarded as the most common type of fall-related injury among elderly because of their high morbidity, mortality and impairment in quality of life.[3]
Osteoporosis is currently considered a chronic condition characterized by a reduction in bone mass, usually because of aging, leading to a reduction in bone strength and an increase in the risk of fracture. Women are more likely to have a hip fracture than men.[4] A stress injury occurs when abnormal stress, usually in the form of frequent repetition of otherwise normal stress, is exerted on a bone with normal elastic resistance but unaccustomed to that action. Stress fractures, mostly tibia and femoral fractures, are common in athlete and military populations, in which subjects are exposed to a sudden increase in physical training.[4]
Risk factors for hip fracture include:
- Osteoporosis
- Low Bone Marrow Density [5]
- Age> 65 years = risk group
- Gender: women have more fractures than men
- Physical inactivity
- and others such as alcohol use, vitamin D and calcium deficiency, smoking, ...[6][7]
However the evidence that calcium supplements reduce fracture risk is lacking.[8]
Characteristics/Clinical Presentation[edit | edit source]
Specific features for patients with hip fracture include:[7] [9]
- Dull ache in the groin and/or hip region [10]
- Inability to put weight on the injured leg causing immobility right after the fall [11]
- If the femur bone is completely broken the injured leg might be shorter compared to the other leg
- Severe pain
- The patient tends to keep the injured hip as still as possible, positioning it in external rotation [11]
- A swelling might occur
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References[edit | edit source]
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- ↑ 1.0 1.1 ANTAPUR ET AL. Fractures in the elderly: when is a hip replacement a necessity? Clinical Interventions in Aging. 2011
- ↑ KAPANDJI I.A. Bewegingsleer Deel II De Onderste Extremiteit. Bohn Stafleu Van Loghum. Houtem/Diegem 1986
- ↑ TANNER ET AL. Hip fracture types in men and women change differently with age. BMC Geriatrics. 2010, 10:12
- ↑ 4.0 4.1 DRAGOI D., POPESCU R. ET AL. A multidisciplinary approach in patients with femoral neck fracture on an osteoporotic basis. Romanian Journal of Morphology and Embryology 2010, 51(4):707–711 Cite error: Invalid
<ref>tag; name "bron twee" defined multiple times with different content - ↑ CAULEY A. J. Risk Factors for Severity and Type of the Hip Fracture. Journal of Bone and Mineral Research. Volume 24, Number 5, 2009
- ↑ LEYTIN and BEAUDION. Reducing hip fractures in the elderly. Clinical Interventions in Aging 2011:6
- ↑ 7.0 7.1 http://www.mayoclinic.com/health/hip-fracture/DS00185/DSECTION=risk-factors (visited on april 2011)
- ↑ SEEMAN E. Evidence that Calcium Supplements Reduce Fracture Risk Is Lacking. Clinical Journal of the American Society of Nephrology 5: S3–S11, 2010
- ↑ http://orthoinfo.aaos.org/topic.cfm?topic=A00392 (visited on april 2011)
- ↑ DORNE and LANDER. Spontaneous Stress Fractures of the Femor Neck. AJA 144:343-347, February 1985
- ↑ 11.0 11.1 SHOBHA S. RAO, M.D., and MANJULA CHERUKURI, M.D. Management of Hip Fracture: The Family Physician’s Role. www.aafp.org/afp Volume 73, Number 12, June 15, 2006
