II. Pathophysiology
- Often results from minimal to no injury
III. Risk Factors
IV. Diagnosis
- See Hip Fracture
- Images
V. Types: Garden Classification
- Non-displaced Fractures (20%)
- Type 1: Stress Fracture - Valgus impaction of head
- Type 2: Complete, non-displaced Fracture
- Displaced Fractures
- Type 3: Varus displacement of femoral head
- Type 4: Fracture fragments completely displaced
VI. Management
- See Hip Fracture
- Strongly consider regional Nerve Block in hip and Femur Fractures
- Fascia Iliaca Block or PENG Block in isolated Femoral Neck Fracture (without Coagulopathy or other contraindication)
- Non-displaced Fracture (Type 1 or 2)
- Bone impaction provides Fracture stability
- Bedrest results in 90% union
- Open reduction and Internal Fixation: 100% union
- Displaced Fracture (Type 3 or 4)
- Closed reduction and pinning
- Preferred in young patients to avoid hip arthroplasty
- Risk of Hip Avascular Necrosis
- Open reduction and Internal Fixation
- Lower morbidity (decreased blood loss and deep Wound Infection) when compared with arthroplasty
- Arthroplasty (acetabulum and femoral head replacement) or Hemiarthroplasty (femoral head replacement)
- Preferred option in older patients (over age 65 years)
- Lower reoperation rates
- Lower risk of avascular necrosis and nonunion
- Faster recovery
- References
- Closed reduction and pinning
VII. Complications
- Non-union
- Avascular Necrosis
- Types 3 and 4 confer 10% risk
-
Osteomyelitis or Septic Arthritis of the hip
- Reduced risk with perioperative Antibiotics
-
Pulmonary Embolism
- Leading cause of death at 7 days post-Fracture
VIII. References
- Gurr in Marx (2002) Rosen's Emergency Med, p. 655-60
- Schmidt (2002) Orthop Clin North Am 33(1):97-111 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
Definition (MSH) | Fractures of the short, constricted portion of the thigh bone between the femur head and the trochanters. It excludes intertrochanteric fractures which are HIP FRACTURES. |
Concepts | Injury or Poisoning (T037) |
MSH | D005265 |
ICD9 | 820 |
ICD10 | S72.0 , S72.00 |
SnomedCT | 157233005, 208520007, 5913000 |
English | Femoral Neck Fracture, Femoral Neck Fractures, NOF - Fracture neck of femur, Femur Neck Fracture, Femur Neck Fractures, fracture of neck of femur (diagnosis), fracture of neck of femur, Fractured femoral neck, Fractured neck of femur, Fracture of neck of femur NOS, Femoral Neck Fractures [Disease/Finding], fracture femoral neck, femur fracture neck, femur neck fracture, neck of femur fracture, femoral neck fracture, femoral neck fractures, Fracture;neck of femur, femoral fracture neck, femur fractures neck, fracture neck femur, fracture neck of femur, fracture of neck femur, femoral fractures neck, femur fractured neck, fractured neck femur, Fracture of neck of femur, NOF - Fracture of neck of femur, Femoral neck fracture, Fracture of neck of femur (disorder), femur fracture; femur neck, femur neck; femoral fracture, femur; fracture, neck, fracture; femur, neck, fractured neck of femur |
Italian | Frattura del collo del femore, Collo femorale fratturato, Fratture del collo del femore |
Dutch | gebroken femurhals, fractuur van femurhals, femur; fractuur, hals, femurhals; heupfraktuur, fractuur; femur, hals, heupfraktuur; femurhals, femurhalsfractuur, Collum femorisfraktuur, Femurhals, fracturen van, Fracturen van femurhals, Fractuur van femurhals, Fractuur, femurhals- |
French | Col du fémur fracturé, Col fémoral fracturé, Fracture du col du fémur, Fractures du col fémoral, Fractures cervicales du fémur, Fractures du col du fémur |
German | Fraktur des Oberschenkelhalses, gebrochener Oberschenkelhals, gebrochener Hals des Oberschenkels, Schenkelhalsfraktur, Oberschenkelhalsfraktur, Schenkelhalsfrakturen, Fracturae colli femoris |
Portuguese | Colo do fémur fracturado, Fractura do colo do fémur, Fraturas do Colo Femoral |
Swedish | Lårbenshalsfrakturer |
Japanese | ダイタイコツケイブコッセツ, 骨折-大腿骨頸部, 大腿骨頸部骨折, 大腿骨頚部骨折, 大腿骨骨折-頸部 |
Czech | femur - fraktury krčku, Zlomený krček femuru, Zlomený krček kosti stehenní, Zlomenina krčku femuru |
Finnish | Reisiluunkaulan murtumat |
Russian | SHEIKI BEDRA PERELOMY, BEDRA SHEIKI PERELOMY, БЕДРА ШЕЙКИ ПЕРЕЛОМЫ, ШЕЙКИ БЕДРА ПЕРЕЛОМЫ |
Spanish | Cuello de fémur fracturado, fractura del cuello femoral (trastorno), fractura de cuello de fémur, fractura del cuello del fémur, fractura del cuello femoral, fractura de cuello de fémur (trastorno), Fractura del cuello del fémur, Fracturas del Cuello Femoral |
Korean | 넓적다리경부의 골절 |
Croatian | FEMUR, FRAKTURE VRATA |
Polish | Złamania szyjki kości udowej |
Hungarian | Combnyaktörés |
Norwegian | Fractura colli femoris, Lårhalsbrudd |
Ontology: Fracture of unspecified intracapsular section of neck of femur, closed (C0159811)
Concepts | Injury or Poisoning (T037) |
ICD9 | 820.00 |
English | Fracture of unspecified intracapsular section of neck of femur, closed, Fx femur intrcaps NOS-cl, Closed fracture of intracapsular section of neck of femur, unspecified |
Dutch | fractuur van niet-gespecificeerd intracapsulair deel van femurhals, gesloten |
French | Fracture fermée d'une section intracapsulaire non précisée du col du fémur |
German | Fraktur eines unspezifischen intrakapsulaeren Abschnitts des Oberschenkelhalses, geschlossen |
Italian | Frattura chiusa di sezione intracapsulare non specificata del collo del femore |
Portuguese | Fractura fechada de parte intracapsular NE do colo do fémur |
Spanish | Fractura de sección intracapsular no especificada del cuello del fémur, cerrada |
Japanese | 大腿骨頚部部位不明の関節包内骨折、閉鎖性, ダイタイコツケイブブイフメイノカンセツホウナイコッセツヘイサセイ |
Czech | Zlomenina blíže neurčené intrakapsulární části krčku femuru, zavřená |
Hungarian | Combnyak intracapsularis részének nem meghatározott törése, zárt |
Ontology: Other closed transcervical fracture of neck of femur (C0159815)
Concepts | Injury or Poisoning (T037) |
ICD9 | 820.09 |
Dutch | andere transcervicale femurfractuur, gesloten |
French | Autre fracture transcervicale du fémur fermée |
German | sonstige transzervikale Fraktur des Oberschenkels, geschlossen |
Italian | Altra frattura transcervicale del femore, chiusa |
Portuguese | Outra fractura transcervical fechada |
Spanish | Otras fracturas transcervicales del fémur, cerradas |
Czech | Jiná transcervikální zlomenina femuru, zavřená |
English | Fx femur intrcaps NEC-cl, Other closed transcervical fracture of neck of femur, Other transcervical fracture of femur, closed |
Hungarian | Egyéb transcervicalis zárt femur-törés |
Ontology: Subcapital fracture of neck of femur (C0347808)
Concepts | Injury or Poisoning (T037) |
ICD10 | S72.01 |
SnomedCT | 263226008 |
English | Intrcapsr frac neck of femur, Subcapital frac neck of femur, Subcapital fracture of femur, subcapital fracture of neck of femur, subcapital fracture femur, subcapital femur fracture, intracapsular fracture of femur, intracapsular fracture of femur (diagnosis), fracture of neck of femur intracapsular, Subcapital fracture of neck of femur (diagnosis), fracture of neck of femur subcapital, Intracapsular fracture of neck of femur, Subcapital fracture of neck of femur, Subcapital fracture of neck of femur (disorder) |
Spanish | fractura subcapital de cuello de fémur (trastorno), fractura subcapital de cuello de fémur |