Fracture of the femoral neck in the elderly
A hip fracture is an injury that results in an injury to the part of the human skeleton that is responsible for connecting the femur to its head. This problem is especially relevant for people who have crossed the 65-year-old milestone.
According to statistics, such an injury accounts for up to 6% of all cases of damage to the bones of the skeleton (fractures).
Content:
- Causes of a hip fracture in the elderly
- Symptoms of a hip fracture in the elderly
- Diagnostics
- Treatment of a hip fracture in the elderly
Causes of a hip fracture in the elderly
Among the risk factors for pensioners are the following:
- Osteoporosis is one of the main reasons affecting the incidence of hip injury among older people. The disease leads to fragility of bones, which increases the risk of injury, even with a slight load. So, slipping and falling even from the height of his own growth, a person can get a fracture.
- Cancer, the risk of which only increases with age.
- Lack of exercise, muscle weakness, inadequate bone nutrition. This is due to the sedentary lifestyle that older people often lead.
- Obesity. It is caused by various diseases, for example, diabetes mellitus and problems with the cardiovascular system, as well as insufficient physical activity.
- Insufficient nutrient content in food.
- The entry of a woman into menopause, in connection with which all bones become fragile and brittle.
- Obliterating endarteritis, atherosclerosis, diseases of the nervous system and other pathologies.
Naturally, one cannot ignore such reasons as: road accidents, falls from great heights and injuries sustained at work, but, as a rule, for older people they are not as relevant as for young people.
Symptoms of a hip fracture in the elderly
Among the main symptoms of trauma are the following:
- Painful sensations that are localized in the groin area. Their intensity is not too strong, since such a fracture is a pathological injury. Due to the fact that discomfort does not bother a person too much, he may not seek medical help for a long time. Moreover, in the absence of movement, the pain can disappear completely.
- Sometimes there is a pronounced dysfunction of the leg. After being injured, it is not possible for a person to walk or stand.
- If a person lies in a relaxed state, then the leg will be turned outward, this can be determined during examination.
- The leg does not turn inward.
- If you try to push or tap on the heel, the person will experience pain.
- When the fracture is varus, a shortening of the leg can be noticed.
- The presence of a hematoma, which appears several days after the fracture. The location is the groin area.
When the fracture is of the impacted type, then the symptoms may be practically absent, and the only manifestation of the injury is pain in the groin area. In this case, the person continues to walk without seeking medical help. But when, after a few days, splitting occurs and the fragment comes out of a nearby bone, all the signs characteristic of non-punctured fractures will appear.
Diagnostics
To clarify the nature of the injury, an X-ray examination is necessary. To avoid doubts, it is carried out in two projections. These are anterolateral and lateral. In rare cases, additional images are required, in other projections. As a rule, when the thigh is strongly adducted or abducted from the midline.
Treatment of a hip fracture in the elderly
Therapy for a hip fracture for elderly patients is somewhat different from the treatment of similar injuries in young people and proceeds with the following features:
- If conservative therapy is required, then it should take place in a hospital, in a specialized department of traumatology.
- In order for fusion to occur, it is necessary to use the skeletal traction method. A person will have to spend a long time without movement, about 2 months. Therefore, from the very first days, the doctor begins to engage in specialized exercises with the patient.
- When the traction is canceled, the person will move independently, but with the help of crutches and without support on the injured leg.
- After 4 months, the limbs can be given loads, but they must be strictly dosed and performed under medical supervision.
- After six months of treatment, you can try to walk on your own using the injured leg.
- If the course of treatment and rehabilitation is completed in full, then the person can return to his previous life 7 months after the injury.
Surgery
Treatment of this type of injury with skeletal traction takes an impressive time span. It is quite difficult for older patients to withstand such a long period without movement, since various complications arise that lead to death. Therefore, if surgical intervention is possible, then it is a priority. And the earlier the operation is done, the better. For this purpose, osteosynthesis is most often used, that is, the fixation of fragments using metal structures. For this, special screws, screws, nails are used. If it is impossible to restore the integrity of the bone, arthroplasty is required. That is, the replacement of the human hip joint with a similar, but artificial one.
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Rehabilitation after fracture
As activities aimed at developing the joint, improving blood supply and increasing muscle tone, the following are recommended:
- Therapeutic gymnastics, with the selection of individual complexes.
- Massage, not intense, but light, carried out in short sessions.
- Psychotherapy courses. To withdraw an elderly patient from a depressive state.
- Physiotherapy
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
