![]() On the other hand, compression fractures tend to be stable and can be managed non-operatively.Ī small percentage of patients may have a risk of a future fracture. Tension fractures are potentially unstable and may require operative management.Neither treatment may offer much benefit in patients with severe cognitive impairment.The replacement is said to be complete when the acetabulum, and femoral head and neck are all replaced and termed partial if the head and neck alone are replaced. In general, hip replacement surgery is considered the better option in an elderly patient with fairly good mobility prior to surgery and good cognition.The choice is made depending on the mobility, degree of independence and cognition of the patient. In elderly patients with displaced fracture, treatment options include open reduction and internal fixation or prosthetic replacement.The chances of returning to a high level of sport participation is poor. Early open reduction and internal fixation is considered the treatment of choice. A displaced fracture in a young patient is considered an orthopedic emergency.Displaced fractures - Management of displaced femoral fractures depends on the age and mobility of the patient.If pain does not lessen or there is evidence of fracture line expansion, internal fixation with multiple parallel lag screws or pins is indicated. Plain x-rays needs to be taken every 2 – 3 days to monitor the progress. Nondisplaced femoral neck fractures have to be initially treated with complete non–weight-bearing ambulation with using crutches.The choice of surgery generally depends on the site and severity of the fracture, whether the broken fragments retain their alignment or not ( displaced fracture), age, and any underlying health conditions. A few patients may require to be fitted with an external device to control excessive pronation that may lead to increased stress on the femoral neck and increase risk of fracture. He can evaluate the patient for gait or anatomic abnormalities that may have caused the fracture.There should be no weight bearing on the affected hip, and suitable strengthening exercises may be prescribed that avoid weight bearing. For fitness, the remaining extremities may be exercised.A physical therapist may be necessary to reinforce the physician's instructions for rest and helping the patient modify his or her training program to allow healing.Modifying one's risk factors is critical at this point to prevent progression of the fracture. In uncomplicated fractures, especially those in younger athletes, treatment must focus on rest and reversal of any training errors.The aim of treatment in patients with femoral neck fractures threefold, namely - to promote healing, prevention of complications, and return of normal function. Several factors need to be considered before a treatment plan is recommended Treatment of hip fracture generally involves a combination of surgery, rehabilitation and drugs. If pain persists in the presence of a normal Plain x-ray, an MRI may be done to rule out a hairline or an occult fracture.īone scans may be indicated when a stress fracture, tumor, or infection is suspected. Garden stage IV : complete fracture, completely displaced.Garden stage III : complete fracture, incompletely displaced. ![]() Garden stage I : undisplaced incomplete, including valgus impacted fractures.Transcervical – midportion of femoral neckĪdditionally, the severity of a subcapital fracture is graded according to the GardenĬlassification of hip fractures as follows:.Subcapital – occurring at junction of femoral head and neck. ![]() All proximal fractures are intracapsular fractures.
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