Femoral Neck Fracture Care by Dr. Mohamed Abas Elbishbishi
What is a Femoral Neck Fracture?
A femoral neck fracture is a break in the upper part of the thigh bone (femur), just below the hip joint. This area connects the main part of the thigh bone to the femoral head, which forms the ball of the hip joint.
Femoral neck fractures are particularly important because the blood supply to the femoral head can be affected by the fracture. If the injury is not treated appropriately, it may lead to problems such as failure of the bone to heal or loss of blood supply to the femoral head.
How Does It Happen?
The cause can vary depending on the patient's age and bone strength:
Older adults
Most commonly caused by a simple fall, especially when the bones have been weakened by osteoporosis.
Younger patients
Usually caused by a high-energy injury such as a road traffic accident or a significant fall.
In some cases,
a very weak bone may fracture during normal activities, even before an actual fall occurs.
Common Symptoms
A femoral neck fracture usually causes significant hip or groin pain and may make walking or putting weight on the affected leg very difficult.
Common symptoms include:
Severe pain in the hip or groin- Pain that may extend to the thigh or knee
- Difficulty standing or walking
- Inability to put weight on the affected leg
- Swelling or bruising around the hip
- The injured leg may appear shorter or turned outward, particularly with a displaced fracture
How Is It Diagnosed?
Diagnosis starts with a clinical examination and imaging, usually X-rays of the hip and pelvis. If the X-ray does not clearly show a fracture but the doctor still suspects one, additional imaging such as MRI or CT may be required.
A correct diagnosis is especially important because some fractures can be subtle or difficult to see on the first X-ray.
Treatment
Proper and timely treatment is essential. The treatment depends on the patient's age, general health, the location of the fracture, and whether the fracture is displaced or stable.
Your rehabilitation program may include:
Non-displaced fractures
These may be treated with surgical fixation using screws or other fixation devices to hold the bone in its proper position.
Displaced fractures
In many older patients, hip replacement is commonly recommended because displacement can damage the blood supply to the femoral head and increase the risk of complications.
Younger patients
Whenever possible, treatment often aims to preserve the patient's natural hip by accurately reducing and fixing the fracture.
Why Early Treatment Matters
A femoral neck fracture should not be considered a simple hip injury. Delayed or inappropriate treatment can increase the risk of complications, including failure of the fracture to heal (nonunion) and loss of blood supply to the femoral head (avascular necrosis). These complications can result in persistent pain, loss of hip function, and the need for additional surgery.
For older patients, hip fractures can also significantly affect mobility and independence, making early treatment and rehabilitation particularly important.
If you have severe hip pain after a fall or injury and are unable to walk or put weight on your leg, you should seek urgent medical assessment.
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