Those are the most prevalent life threatening fractures in advanced age.
Femoral Neck Fractures
Femoral neck fractures consists 1% of all fractures. 80% of the fractures develop over 60 years of age. The prevalence is 4-5 folds more in women. Femoral neck fracture may develop as a consequence of accidental fall or hit on hip side.
Clinic and diagnosis:
The general condition of the patient is not much affected. There is pain on hip region in nondisplaced fractures. The pain emerges on hip when someone hits on ankle or greater trochanter. There is severe pain on displaced fractures and the patients cannot move their leg and the leg is on extroverted position. The diagnosis is made through X-rays. The impacted fractures in osteoporotic patients could be missed on X-rays therefore, computed tomography may be performed for diagnosis.
The recovery of femoral neck fractures is difficult. The circulation in femoral head is impacted due to fracture and femoral neck avascular necrosis may develop. Therefore, surgery is the only treatment option in all age groups. Hip compression nails are used in adults after femoral head partial prosthesis in elderly, and thin multiple nails(Knowles nails) are used for fixation in children to avoid serious damage on epiphysis plaque after anatomic reduction is performed in young patients. Although, the early mobilization and weight bearing are promoted after prosthesis operations, weight bearing after internal fixation operations must be allowed when the reunion is evident on radiologic images. The most important problem after femur fractures is the worsening of the general health in patients. Therefore, the surgery must be performed immediately and the patient must be mobilized shortly after the procedure. Otherwise, the patients may die due to heart and respiratory failures.