Femoral Neck Fracture Powerpoint final

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Femoral Neck Fracture :

Femoral Neck Fracture Angie Mason Bela Mistry Somadina Umeh

Types of Femoral Neck Fractures:

Types of Femoral Neck Fractures All Intracapsular Subcapital Transcervical Basilar (base of neck) Garden’s Classification I- Incomplete II-Complete but undisplaced III-Partially Displaced IV-Completely Displaced

Incidence:

Incidence Approximately 250,000 people have hip fractures per year in the U.S. Almost 50% of those are in people over the age 80. More commonly seen in females than in males 95% of femoral neck fractures are displaced

Causes of Femoral Neck Fracures:

Causes of Femoral Neck Fracures Falls Osteoporosis Trauma “The fracture is the cause of the fall rather than the result of it.”-Salter

Signs and Symptoms:

Signs and Symptoms Difficulty walking Swelling in leg Inability to walk Severe pain Bruising over hip joint Low back pain Foot turned out at an odd angle (external rotation)

Diagnosis/ Prognosis:

Diagnosis/ Prognosis Diagnosis X-ray MRI CT-scan Prognosis Variable 1 in 4 patients die within a year of the injury Prognosis “ The Unsolved Fracture” Prone to multiple complications One of the most difficult fractures to treat Healing duration is dependent on endosteal callus formation PT Prognosis Depends on type of injury, age, co-morbidities, and treatment compliance.

Role of Imaging:

Role of Imaging Degree of damage Location of fracture Total hip arthroplasty alignment Angle of femoral head in acetabulum

Form of Imaging BEST used:

Form of Imaging BEST used Anterior-Posterior on a standard radiograph Lateral view on a standard radiograph

Radiographic Features (A/P View):

Radiographic Features (A/P View) Neck of Femur appears shortened Distal fragment External Rotation Shifted Proximally A/P and Lateral views are required to establish proper alignment between fragments

Images and Findings:

Images and Findings

Biomechanical Concerns:

Biomechanical Concerns Leg length discrepancy Avascular Necrosis More common in Type III & IV Decreased femoral neck angle Delayed union and malunion

Treatment:

Treatment Surgical Total Hip Arthoplasty Rehabilitation PT Improve range of motion Functional tasks Gait Strengthen weaken muscles

Questions:

Questions 1. Name 3 interventions a PT could implement to increase ROM, strength, and function for a patient with a posterior-lateral approach and why. 2. Using ABC’s identify the common characteristics you would see on a standard radiograph image for a femoral neck fracture.

References:

References Salter RB. Textbook of Disorders and Injuries of the Musculoskeletal System. Baltimore, MD: Williams & Wilkins; 1999: 632-640. Medical Disablility Guidelines. Femoral Neck Fracture . http://www.mdguidelines.com/fracture-femoral-neck. Accessed May 31, 2012. The University of Chicago-Medicine. Hip Fracture . http://www.uchospitals.edu/online-library/content=P08957. Accessed May 31, 2012. Wheeless’ Textbook of Orthopaedics. Fractures of Femoral Neck . http://www.wheelessonline.com/ortho/fractures_of_the_femoral_neck. Accessed June 7, 2012