Fracture of the femoral neck in old age: the consequences may be irreversible

Fracture of the neck of the hip joint is attributed to severe and fairly frequent injuries to the musculoskeletal system. At a young age, this is rare. The fact is that this requires a fairly strong blow - a fall from the height or a serious injury, obtained, for example, in a traffic accident.

A completely different picture is observed in elderly people. Over the years, the strength of bones is significantly reduced. The reason for this is osteoporosis, in which their thinning and rarefaction occurs. Bones become brittle and brittle.

Clinic of the disease

It is difficult to bear a fracture of the femoral neck in old age. The consequences can be the most unpredictable - lead to disability or even death. Fractures are divided into three types:

• In the region of the neck of the thigh;
• In the region of the femoral head;
• In the area of a large trochanter.

Also they are divided into:

• Median (medial) - intraarticular fracture;
• Lateral (lateral) - extra-articular fractures;
• Fractures in the perpendicular area, which are typical of the elderly even with moderate trauma.

Symptoms

Fracture of the femoral neck in old age - the effects of injuries, infections of bone tissue, malignant or benign tumors. The defeat is marked by pronounced symptoms:

• Moderate concentrated groin pain increases with minor heel attacks on the side of possible damage.
• The broken leg is unnaturally slightly turned outwards.
• There is a shortening of the broken leg - a damaged bone allows the muscles to pull the limb closer to the thigh.
• The symptom of the "stitched heel" - with the possible flexion-extensor movement, it is impossible to support the straightened leg on the weight.

If the patient received a fracture of the femoral neck in old age, the consequences of this are primarily detrimental to his psycho-emotional state. There is nervousness, capriciousness, frequent changes of mood. First of all, due to forced immobility. Immediately there are problems that require endurance and patience.

Treatment

The probability of independent bone splicing is very low, primarily due to the features of the structure of the femoral neck and its blood supply. Therefore, to treat a fractured neck of the femur in old age (the consequences of possible complications can not be predicted) is very difficult. In many countries this issue is solved radically - by surgical intervention.

1. Fixation of fragments of the femoral neck with cannulated screws - osteosynthesis. Full freedom of movement (independently) after the operation is possible after four months. But even with this method, there are failures. Because of the growth of bones, there is a high probability of forming a false joint.

How to treat a fracture of the neck of the hip, depends on many factors. The older the patient and the longer the time from the time of injury, the greater the risk of failure. The optimal age of the patient in this case is up to 60 years.

2. Replacement of the hip joint with an artificial joint - endoprosthetics.

The optimal age of the patient is from 60 to 80 years. After confirming the diagnosis of a "hip fracture", treatment, surgery (the way it is carried out) is determined by the doctor, taking into account the individual and age characteristics of the patient.

3. Patients with multiple concomitant diseases that have contraindications (heart disease, diabetes mellitus), and those who have little chance of safely reschedule the operation, are assigned non-surgical conservative treatment .

We said this about the official side. But the long practice of treating such fractures has shown that no conservative treatment will help, if there was a fracture of the femoral neck in old age, the consequences will still lead to death. Doctors were forced to go to the trick and apply the tactic of "lie to rescue." Patients were informed that there was no fracture, only a severe bruise. Anesthetics were prescribed, a gingival lapet or an orthopedic boot was applied to fix the external foot. But the main focus was on the need for active movement, which is an excellent and most important prevention of the consequences:

• Education of decubitus.
• Disturbances of pulmonary blood flow, which inevitably leads to pneumonia.
• Hypodinamy, which negatively affects the work of the intestines and is the cause of constipation.
• Absence of loads on the anchor muscles causes a violation of the venous circulation, which will lead to thrombosis of the veins of the lower extremities.
• Asthenic syndrome. After two months of bed rest, the patient's physical weakness is so obvious that he can not only walk himself, but also sit down.

As soon as the pain subsides a little, the patient is allowed to sit, lowering his legs from the bed. In two weeks you can stand with the help of walkers or crutches. After three weeks, you should move as much as possible, relying on something.

The method of such treatment is not aimed at providing fracture fusion - at this age it is simply impossible, but to adapt the patient and teach him to live with such damage.

Surprisingly, it is this position that has allowed to save the life and activity of many patients. The tactics of the early activity of patients today are universally recognized.