Fracture of the neck of the thigh - symptoms, signs, diagnosis. Treatment of a fracture of the neck of the thigh without surgery and with surgery. How is the restoration after a fracture of the hip neck. How to properly care for patients with a fracture of the hip neck

Such an injury as a fracture of the femoral neck is rather painful, requiring a long period of recovery. If we talk about the frequency of such injuries, then the neck of the thigh suffers in 6% of cases. A fracture of the neck of the thigh is often perceived by people as a real sentence. After all, the hip joint is a joint that takes on the largest load while walking. In this article, we will consider the symptoms by which you can suspect a fracture of the hip neck, consequences, the nature of treatment and the features of recovery after such a serious injury.

Fracture of the neck of the thigh. Symptoms

There is a certain list of signs by which you can suspect a fracture of the hip neck. Of course, this information is exclusively introductory for the patient, since the right to determine the diagnosis belongs only to the doctor. You may not even feel the moment of the fracture, but according to the following symptoms you can suspect the presence of an injury:

• violation of the functions of the leg. This symptom is expressed in the impossibility of relying on the affected leg, walk, stand;
• pain for the fracture of the neck of the thigh in the groin. The fracture of the neck of the thigh is not always accompanied by acute pain. In moments of rest, the patient may not feel anything at all. Aching pain, as a rule, occurs when trying to move, turn the leg;
• the leg is turned outside. In the position of lying, the patient with a fracture of the neck of the thigh may notice that the knee and foot are turned out. This symptom is explained by the features of the combination of muscles and bones. Sometimes such a symptom may indicate simply about the physiological structure of the leg. If you observe other signs of a fracture of the neck of the thigh, then there is most likely trauma;
• inability to turn the leg inward. Such a sign, as a rule, always means the presence of an injury;
• painful sensations when pressing the heel of the injured leg. This feature can also be explained by the features of the bones of the muscles and bones of the skeleton. With an axial load, the patient will feel pain;
• shortening the legs. This symptom is one of the most invisible. With a certain form of a fracture of the neck of the thigh, a slight shortening of the injured leg occurs;
• a characteristic sound of the crunch when trying to make the movement of the injured leg;
• painful sensations on palpation of the injured joint;
• changing the color of the skin above the joint. The hematoma above the fracture site does not appear immediately after the injury, but a few days later.

A patient with a fracture of the neck of the thigh may not immediately understand that he has an injury and, accordingly, do not immediately consult a doctor. This is due to the fact that with the injected nature of the fracture, all of the above symptoms may be absent. The function of the leg is not impaired, and a person feels only minor pains in the groin, which he may not attach significance. Only a few days later, almost all signs of a fracture of the neck of the thigh appear, which makes a person seek medical help.

Fracture of the neck of the thigh. Types

There are several classifications that allow you to indicate the type of fracture of the hip neck.

• depending on the anatomical arrangement of the fracture of the femoris, the injury is divided into basceumvical (a fracture occurred at the very base of the femoral neck), transcrivical (a fracture occurred on the very neck of the thigh), subcapital (a fracture occurred in the immediate vicinity of the femoral head);
• depending on the degree of displacement of the fractures of the fractures of the hip, the hips are divided into a valgus type (incomplete fracture), a fracture of the hip neck with a break, but without displacement, a fracture of the neck of the thigh with a partial displacement, a fracture of the hip neck with a displacement of fragments;
• depending on the nature of the injury, the open fracture of the hip neck and a closed fracture of the neck of the thigh are distinguished.

Crazy Fracture of the Bip

A fracture of the thigh is a fracture between the base of the neck of the thigh and the subject line. Such an injury is often everyday nature in people of retirement age. The main symptoms of a short thigh fracture are:

• acute pain;
• edema;
• hematoma at the fracture site;
• the victim also cannot rely on the sore leg;
• large blood loss is possible;
• the general condition of a person is bad.

If a person has received such an injury, then it is very important not to try to transport it, to try to raise your own before the arrival of the ambulance team. The leg needs to be immobilized and fixed. Treatment of such an injury can be both surgical and conservative depending on the severity of the fracture.

Hip fracture

A hip in a fracture of the hip is an injury that has a huge amount of chances to be not diagnosed in time. A similar fracture of the neck of the thigh in age often occurs as a result of too much load on the leg, too intense walking. A person does not feel the moment of the fracture, because the mobility of the leg does not suffer. Think about the fact that something is wrong, it can make periodic aching pain. The danger of a hidden fracture of the neck of the thigh is that it can develop into non -shaped. For the decision of the correct diagnosis, the doctor will need to take an X -ray picture in several projections.

Fracture fracture of the neck of the thigh

Fracture fracture of the femoral neck is most often found in women. The main symptoms of this injury are:

• rather vast swelling of the damaged place;
• pain in a damaged place;
• the inability to step on the heel;
• bruises over the fracture site.

Patients, although they need surgery, antibiotic therapy, the injury has a favorable outcome. In the recovery period, after the operation, healing physical education is prescribed.

Open fracture of the neck of the thigh

This type of injury is one of the most painful. An open fracture is characterized by a rupture of soft tissues and the output of bone fragments. Often such injuries occur due to gunshot wounds. As already mentioned, the main symptoms of the open fracture of the hip neck are acute pain, significant blood loss, and gap of soft tissues.

Closed fracture of the neck

Closed fractures of the hips most often overtake the elderly people as a result of falling, blow. Depending on where a fracture occurred, a pain focus is felt.

• If a fracture occurred in the lower thigh, then it is impossible for a person to move his foot, turn it, bend it;
• if a fracture occurred inside the joint, then the injury is accompanied by pain of medium intensity.

In the treatment of a closed fracture of the hip neck, it is important to pump out stagnant blood from the joint. If the separation of fragments has occurred, then it is necessary to make their reposition. If you connect all the fragments are not possible, then the joint is replaced by a new one. In the treatment of a closed fracture of the hip of the thigh in the elderly, doctors try to avoid long -term stretching of the legs, since bed rest for a month or more in this category of people is able to provoke the appearance of complications of other diseases.

Fracture of the neck of the thigh. Consequences

So, can any complications happen after a fracture of the neck of a person? As with any injury, of course, they can. This can happen due to untimely seeking medical help, due to improper transportation of the patient, due to non-compliance with the doctor’s recommendations in the postoperative period. Consider the most common consequences after such an injury:

• necrosis of the bone head. Sometimes it can happen that the bone head either partially collapsed, or completely. Doctors advise patients who have a risk of dying of the bone head, carry out the prosthetics procedure as a prevention. Do not refuse the operation or put it off for an indefinite period;
• false joint formation. Sometimes it may happen that the fragments did not grow together after the operation. The patient may feel discomfort when walking. In this case, re -surgical intervention is required;
• thrombosis veins. One of the most dangerous complications that can happen after a fracture of the hip neck. This is most often due to a long recovery period, a long bed rest, the lack of movement of the damaged leg. Blood supply in the damaged area is disturbed, and blood clots in the veins may occur. Thrombosis can cause the patient's sudden death. That is why the correct rehabilitation after a fracture of the hip neck is very important;
• pneumonia, bronchitis. As a result of the fact that the victim is in a lying position for a long time, the lung function may be impaired. Sputum can stagnate in them, which leads to bronchitis or inflammation of the lungs. It is very important for patients who prescribed bed rest to perform breathing gymnastics in order to avoid the risk of such complications;
• complications after surgery in the form of a loosening of metal elements, too deep installation of the screws in the bone. During the operation, blood vessels or nerve endings can also be touched;
• rejection of metal elements. Such a complication refers to the late consequences of the operation;
• risk of bacterial infection during surgery;
• the risk of pressure sores with a long bed regime;
• the negative psychological condition of the patient due to a long stay in a medical institution. A person may even become depressed, to feel the hopelessness of the situation. It is very important to make care and attention to their relatives, who faced such a severe injury;
• the possibility of arthrosis, joint contractures. People who have experienced the treatment of a fracture of the hip neck should be regularly examined by the doctor and be under supervision, to react to any changes sensitively.

Patients with a fracture of the neck of the thigh. First aid

If you are next to a person who received a serious injury, then it is very important to behave correctly in such a situation. Let us consider in more detail the approximate plan of your actions:

• do not panic and calm down. The injured person needs immediate help, and the state of panic will only interfere with this;
• call the ambulance team;
• a person who received a fracture of the neck of the thigh may experience very severe pains. Give him any painkillers (ibuprofen or ketorol);
• with open fractures, it is better not to try to independently transport a person at all. The most correct solution would be to wait for the ambulance;
• if it is cold outside, then insulate the injured limb, since it will be more severe to frostbite. In the warm season, you should also not free a person from clothes;
• if the situation develops in such a way that you need to transport a person with a similar fracture, then it is very important to immobilize and fix the limb. Put the tire from the inner surface of the leg, ranging from the groin to the heel. The leg should be fixed at three points - near the ankles, near the knee and in the groin;
• take care of what you will endure the victim. You need to find any solid surface. Of course, the best option would be a stretcher. But you can use the door from the cabinet, plywood sheet, countertop;
• if there is bleeding on the injured leg, then you also need to take care of stopping it. To do this, apply a tourniquet. If the limb began to change the color after that, then the tourniquet is superimposed too tight and it must be loosened;
• take carefully to the psychological state of a person who has received such a serious and painful injury. He can scream and moan in pain, or he can be in a state of shock.

Fracture of the neck of the thigh. Care and treatment

How to treat a fracture of the hip neck

The treatment scheme for a fracture of the hip neck depends on the type of fracture. Consider the most general points in the treatment of some types of such injuries:

• the most “simple” treatment regimen has a broken fracture of the hip neck with a horizontal fracture line. If a fracture has a vertical line, then it has every chance of developing into a split fracture of the hip neck. With a broken fracture, the patient is applied to the gypsum langet for 3-4 months. A person can move with crutches, but in no case relying on a sore leg;
• with a fracture of the neck of the thigh, a “hood” of the skeleton in a hospital may also be needed. The leg is suspended in a raised state with a load of about 2-3 kg. In this position, the patient can be about 2 months. Over this time, it is important to engage in physiotherapy exercises with the patient. After the time of the extract of the legs in the hospital, the patient is applied to the patient, and he gets the opportunity to move on crutches. After 3-4 months, you can begin to rely on the injured leg, but under the strict supervision of a doctor. Complete mobility to the leg will return on average after 6 months;
• if the fracture of the neck of the thigh was with a displacement of fragments, then the load for retracting the legs is about 6-8 kg.

If such a conservative treatment of a fracture of the hip neck is impossible for a number of medical reasons, then surgical intervention is shown. With a fracture of the hip of the thigh, the operation must be carried out as soon as possible, in an emergency order. If the operation cannot be carried out in an emergency, then the patient is placed on an “hood”, and then operated. Surgical intervention is carried out under general or local anesthesia. Surgeons choose an open method of operating or closed, depending on the severity of the injury. When conducting such surgical interventions,:

• three-lobed nails of Smith-Petersen;
• knitting needles;
• screws;
• dynamic femoral screw;
• total prosthesis;
• monopolar prosthesis of the femoral head;
• bipolar prosthesis of the femoral head.

How to care for a patient with a fracture of the neck of the thigh

As you already understood, the recovery period after a fracture of the hip neck can take about six months. This is a fairly long time, during which the proper care of the victims is very important. A person loses the ability to move independently, becomes helpless, in need of the help of relatives and friends. Let's take a closer look at the care of patients with a fracture of the hip neck in several directions:

• massage. Massage is an obligatory element of the recovery period after a fracture of the hip neck. It is designed to improve blood circulation in the affected leg, return the tone to the muscles, provide the outflow of lymph, prevent the appearance of stagnant processes in the lungs, which can provoke pneumonia. Massage begins to be carried out in short sessions, it should not hurt. It is especially careful to massage with a fracture of the hip neck in older people and people who suffer from arterial hypertension, since massage can provoke an undesirable increase in pressure;
• therapeutic gymnastics. Exercises after a fracture of the hips play a very important role. Firstly, they prevent muscle atrophy, the appearance of pressure sores, and the development of osteoporosis. And secondly, simple exercises have a positive effect on the patient’s psychological condition, restore his motor activity;
• daily care for the lying patient. With a fracture of the femoral neck, treatment at home and in a hospital, it is very important to change bedding in time, to help the patient with washing, brushing tooths, eating, supplying the ship on time, monitor the lack of folds on the sheet;
• drug therapy. Throughout the rehabilitation period, after a fracture of the hip neck, an anesthetic drugs, local anesthesia, and sedatives, sleeping pills, drugs that reduce blood coagulation, drugs that prevent blood flow, and drugs to improve blood flow in blood vessels can be prescribed;
• nutrition. As a rule, in a person who is chained to the bed and cannot move fully, a decrease in appetite is noted. But it is very important for him to gain strength, and nutrition plays an important role in this. The diet of a patient with a fracture of the neck of the thigh should be saturated with dairy and fermented milk products. fresh vegetables, herbs, fruits, cereals;
• psychological help. Native and friends of a person with such a serious injury should surround him with care and attention.  After a fracture of the neck of the lying, it is difficult for the patient to be chained to bed 24 hours a day, he can fall into a depressive state. In a hospital, patients who provide professional psychological assistance can visit patients.

Treatment of a fracture of the hip neck without surgery

Most people are inclined to think that the fracture of the hip shake is the injury that is treated exclusively with surgically. But this is far from the case. The fact that after such an injury a person needs to consult a surgeon, is not even questioned. After conducting studies (X -ray), the doctor will assess the patient's condition, determine the type and nature of the fracture and decide on the tactics of treatment. Sometimes you can do with conservative treatment. This is especially true for patients with a fracture of the elderly hip. The conservative type of treatment for a fracture of the hip neck includes the following therapeutic measures:

• skeletal traction method;
• plaster dressing;
• wearing orthosis;
• taking strong painkillers;
• massage, exercise therapy.

No matter how severe the treatment may be, the patient needs to listen to the instructions of the doctor, follow all his recommendations. Otherwise, you can meet with a huge number of complications.

Fracture of the neck of the thigh. Recovery

Restoration after a fracture of the neck of the thigh is a long -term and requiring effort from the patient. When can you start performing simple restoring exercises? It depends on whether there was an operation or not. If there was no operation, then you can move with crutches only after 2-3 months, and take support for a sore leg-after 5-6 months. If there was still an operation, then doctors allow you to sit in bed in a week, and try to move with crutches-2-3 weeks.

A set of exercises for rehabilitation after a fracture of the hip neck in a lying position

1. Perform simple breathing exercises: inflate a “ball”, alternate deep breaths with deep exhalations, “breathe” the muscles of the press.
2. Actively move your fingers healthy and sore legs.
3. Turn the foot smoothly in different directions, without tearing the heels from the bed.
4. I simulate walking in bed, also connecting the movements of the hands, but without tearing the heels from the bed.
5. Press the body to the bed, straining and relaxing the muscles of the legs, buttocks, shoulders.
6. Perform different exercises for a healthy leg - “bicycle”, “frog”.

Any exercise for a sore leg should be performed on exhalation. Such gymnastics in bed should not bring pain.

A set of exercises for rehabilitation after a fracture of the neck of the thigh in a sitting position

1. Sitting on a chair or on the bed, actively move your fingers, lift and lower them.
2. I simulate walking in a sitting position. Attach to the "walk" with your hands and shoulders.
3. Perform weak tapping with a heel on the floor.
4. Follow the torso to the right and left.

A set of exercises for rehabilitation after a fracture of the hip neck in a standing position

If the doctor allowed the patient to rise and take support on the sore leg, then you can start performing simple exercises. Remember that any of your efforts should not cause pain, when the exercise appears, you should immediately stop.

1. I simulate walking, gradually trying to tear off the heels from the floor.
2. Perform twisting the spine to the left and right.
3. Perform smooth flexion and extension of both knee joints.
4. Perform slow tilts of the body while raising the opposite leg (we strive to the left knee with your right shoulder, we strive for the right knee with your left shoulder).

Fracture of the neck of the thigh. Photo

We wish you and your relatives and friends to never meet with a fracture of the neck of the thigh. If this happened, then follow the recommendations of your doctor. The path to complete restoration after the injury seems infinitely long, but it must be overcome with dignity. Take care of your health!