Fall of the elderly person : to manage a femoral neck fracture

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Following a bad fall, the elderly are more likely to suffer a fracture of the neck of the femur, a fracture of the bone debilitating and should be treated as quickly as possible. How to recognize the signs, and what are the treatments offered ?

chute col fémur

The causes of the fracture of the neck of the femur

The femoral neck fracture is a fracture of the bone of the upper part of the femur, which can occur at the level of the femoral neck (one speaks in this case of cervical fracture) or at the level of the greater trochanter with which it is linked (one speaks in this case of a fracture trochanteric).

Among people under the age of 55 years, this type of fracture usually occurs as a result of severe trauma (car accident, fall from a high place). Among the seniors, on the other hand, it can be caused by a fall banal, at a low height. Women are particularly affected, and represent more than 75% of patients in France.

The femoral neck fracture is favored in the elderly by joint disease and bone diseases, as well as by falls to repetition that are related to other health problems : vision problems, metabolic disorders, intake of sedatives, etc In addition, several risk factors predispose to this type of fracture, such as a late age of first menstruation in women, or a family history (particularly maternal).

The symptoms and treatment of the fracture

The symptoms of fracture of the neck of the femur vary according to the age and subject. Often, an older person will perceive a crack in the top of the leg, and feel a very severe pain in the hip, the buttock and the crease of the groin. She can not move the leg, or even lean over. When the fracture is not complete and that the bones of the neck of the femur to stay in place, the person may, however, continue to walk even though each step is painful. A person who suspects a fracture of the neck of the femur should go to the emergency room as quickly as possible to pass x-ray examinations, to determine the extent of the break.

The femoral neck fracture is treated by surgery, which is scheduled shortly after the diagnosis. The orthopaedic surgeon has the choice between two options : internal fixation, which aims to resolder the bone fragments with screws or plates, or prosthetic joint that is designed to replace some of the bone fragments to reconstruct the joint. If necessary, several models of prostheses are available : a prosthetic limb cervico-cephalic which replaces the head and neck of the femur when the joint is not worn by theosteoarthritis, a prosthesis intermediate comprising a movable part inserted in the basin to reduce the wear of the acetabular cup, or a total prosthesis in the case of osteoarthritis, severe hip.

The possible complications after the operation

Senior citizens are sometimes confronted with complications later on. In the short term, it is a question of difficulties related to the lengthening therapy (phlebitis, urinary tract infection, loss of independence, pressure ulcers) or to a dislocation caused by too rapid a movement. In the medium term, it happens that the fracture develops in a negative (non-consolidation, necrosis of the femoral head, joint infection). On the very long term, it is also possible that the prosthesis wears out or breaks off.

Moreover, some elderly people tend to decrease their physical activity, then it is essential to their well-being. However, prolonged immobilization and the activity stops are part of the main causes of theosteoporosis.

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