![]() Stage 2 – complete or complete fracture without displacement.Without treatment, it can go into a complete fracture. The lower part of the bone breaks like a “green branch”, the upper part turns slightly, which on X-rays creates the illusion of the formation of a punctured fracture. Stage 1 – incomplete or incomplete fracture.3 degree – an angle of more than 50 degrees.Īnd, finally, a number of traumatologists use the Garden classification for an approximate assessment of the viability of the femoral neck and the choice of treatment tactics (within the framework of this classification, only subcapital injuries are considered):.1 degree – an angle of less than 30 degrees.To describe this feature, the Powell classification is used: The more vertically it passes, the higher the probability of displacement and the lower the chances of normal fusion. Subcapital – the fracture line runs close to the femoral head.Īnother important indicator is the angle at which the fracture line is located.Transcervical – the fracture line is located in the center or close to the center of the femoral neck.Basicervical – the fracture line runs at the base of the neck, just above the trochanter.Taking into account this criterion, hip neck fractures are divided into: The higher this line, the worse the blood supply to the proximal fragment and the greater the likelihood of developing avascular necrosis or non-fusion of the fracture. One of the essential criteria is the location of the fracture in relation to the femoral head. ClassificationĪll classifications of these fractures accepted in traumatology and orthopedics are of a clinical nature, reflect the peculiarities of the course of the disease and help to choose the optimal treatment method taking into account specific circumstances. This condition is called avascular necrosis or osteonecrosis of the neck and femoral head. The arteries in the capsule are not enough to adequately supply the bone with blood, so the proximal bone fragment does not grow to the distal one, and in some cases it completely resolves. With fractures of the neck, the proximal fragment is deprived of nutrition from the intraosseous vessels. With age, the blood supply to the femoral head worsens, the vessels narrow, and the artery inside the ligament completely closes and stops “working”. The first is through the vessels located in the capsule of the joint, the second is through the arteries passing inside the bone, and the third is through the vessel located inside the ligament between the femoral head and the acetabulum. The blood supply to the head is carried out in three ways. The neck is located at an angle to the main part of the bone, in the area of the angle there are large and small trochanters. In its peripheral part, the head passes into the neck, and the neck into the body of the femur. Another large ligament is located right in the center of the joint and connects the bottom of the acetabulum with the femoral head. The joint consists of a spherical femoral head and a deep rounded acetabulum, surrounded by a capsule and powerful ligaments. It performs a supporting function and carries a significant load when running and walking. The hip joint is one of the largest joints. In young patients, a hip fracture is usually preceded by a more severe high–energy impact – a car accident or a fall from a height. In elderly patients with a marked decrease in bone strength, trauma can develop even with a sharp tilt or an awkward turn in bed. The immediate cause of the damage is usually a fall on the side of the house or on the street. Hip fracture is a fairly common injury, occurs more often in everyday life and is found in elderly people suffering from osteoporosis. Meanwhile, the lack of qualified care can negatively affect both the condition of the proximal fragment and the general condition of the patient, therefore, if characteristic symptoms occur, you should immediately contact an orthopedic traumatologist. Sometimes patients with fractures of the femoral neck (especially impaled) are treated independently for osteochondrosis, sciatica or hip arthrosis for a long time. Since there is no obvious trauma in the anamnesis, and clinical manifestations are mild or moderate, some patients do not even assume serious injuries and do not immediately turn to doctors. ![]() In elderly patients with osteoporosis, this damage can occur even with minor traumatic effects. In 20% of cases, such injuries cause death. Femoral neck fractures are detected twice as often in women as in men. It accounts for about 6% of the total number of fractures, while in 90% of cases elderly people suffer. Femoral neck fracture is damage to the upper part of the femur.
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