There is both medial and lateral fracture. The first includes a fracture of the head and neck of the femur, the second - intertrochanteric, transtrochanteric and isolated fracture of the trochanter. As medical practice shows, a fracture of the femoral head is not so common.
Assessing the passage of the fracture line, the following fractures are distinguished: subhead, transcervical, basal. Given the position of the limb at the time of injury to the femoral neck, they are divided into abduction and adduction fractures. After an injury, it is important to contact a traumatologist in a timely manner. This will help prevent the development of serious he alth problems. At home, it is impossible to diagnose a pathology.
For what reasons does it occur?
Abduction fracture most often occurs when a person falls on an abducted hip leg due to an increase in the neck-diaphyseal angle. A fracture is called valgus if the patient has fallen on the adducted leg. Under such circumstances, the cervical-diaphyseal angle decreases. Varus fracture is much more common.
Symptomaticspathology
Most often, doctors diagnose a hip fracture and a pertrochanteric fracture in older people who have fallen on an adducted or abducted leg. After injury, severe pain develops in the hip joint. It is difficult to focus on the leg.
Diagnostic Methods
The main methods of diagnosis include examination and physical examination. During the procedure, a patient with a pertrochanteric fracture has an increased pulsation in the area of the femoral joint. The patient feels intense pain. The patient is unable to raise the leg extended at the knee.
Laboratory and x-rays
The patient needs to take a general clinical blood test and take an x-ray in order to determine the damaged areas and the value of the neck-diaphyseal angle. By analyzing blood counts, you can identify the presence of other pathologies and choose the appropriate treatment.
The recovery process of the patient
Fracture of the femoral neck must be treated surgically, with the exception of a valgus fracture and trauma against the background of a general contraindication to surgery.
Conservative treatment
Conservative therapy for a pertrochanteric fracture in a young patient is based on the use of a Whitman plaster cast, which must be worn for several months. After that, it is allowed to walk on crutches. It is undesirable to carry outpressure on the injured area. Only six months later, doctors allow the load. A full and he althy lifestyle is restored after 7 months. Experts do not recommend the use of a hip bandage for older people, as a complication may occur. Most likely, the doctor will apply skeletal traction for the femoral condyles to the patient for 1-2 months. The limb must be abducted 25 degrees and rotated inward. The treatment process includes physical therapy.
During the operation, it is necessary to match and firmly fix the fragments. This can only be done with the help of a surgical method of treatment. There are several types of surgery: open and closed. In the process of carrying out the first method, an arthrotomy of the hip joint is performed. The doctor finds fragments. Then punches the pin. At the end of all necessary actions, the surgeon sutures the wound. Intra-articular methods are rarely used by specialists, since after such a method complications develop in the form of coxarthrosis.
Popular treatment
As the medical practice of doctors shows, surgeons most often use a closed or extra-articular method of surgery. The patient is placed on the surgical chair. With the use of an anesthetic, the fragments are repositioned by abducting the limb by 20 degrees. After the procedure, it is necessary to take an x-ray.
The main task of any type of surgical intervention is to match the bone fragments and fix them with a special pin, plate, or bracket. The fixing element is made by a specialist, depending on the individual characteristics of the person. The resulting x-ray is the basis.
How fast will the patient recover?
The speed of recovery depends on many factors. Among which:
- quality of fixing devices;
- how correctly the fragments are composed;
- kind of fracture;
- presence of complications;
- quality of bone structure.
If a patient has a pathology of the musculoskeletal structure other than a trochanteric fracture of the femur, then several more operations may be needed.
Contraindications for surgery
There are a number of contraindications in which it is not recommended to perform the operation. Namely:
- disorders in the cardiovascular system;
- blood diseases;
- thrombosis;
- endocrine diseases;
- excess purines in the body.
Most often, doctors use an angle plate or a dynamic screw to fix fragments. In some situations, it is necessary to change the mount over time. Often in the process of treating a fracture in an elderly patient, the doctor uses a pin. This design is installed by a specialist through a small incision. After surgery, it is important to wear a special bandage.
Rehabilitation process
When the conservative treatment of the trochanteric fracture is completed, the patient's body will recover within a few months. The first time you need to use crutches. The entire process of patient therapy should be strictly controlled by the attending physician. You should be aware that in older people, the recovery period may be delayed, and complications are often unpredictable. For this reason, you should immediately consult a doctor if your general he alth condition worsens.
Additional treatment
To speed up the period of recovery of the damaged bone structure, the doctor prescribes physiotherapeutic methods of treatment to the patient. Thanks to their implementation, you can improve blood circulation and restore muscle tissue and bones. With the help of massage, laser stimulation, hydrotherapy, heating, electrophoresis, paraffin therapy and therapeutic exercises, you can quickly restore the patient's he alth after a trochanteric fracture of the femur. The functioning of the damaged bone tissue is fully restored only after six months. In a difficult case, rehabilitation can take a year.
What will be the outcome of the treatment?
In the event that you consult a doctor in time and carefully follow all the recommendations, you can quickly restore physical activity. The experience of the attending physician is no less important, therefore it is not recommended to seek help from dubious clinics. With a displaced pertrochanteric fracture, doctors rarely perform surgery.
Note to patient
When one of the signs of a fracture appears, it is important to consult a doctor in a timely manner. First of all, the traumatologist visuallyexamine the patient and palpate the damaged area. The specialist puts the diagnosis on the basis of the result of the patient's examination. It is important to carry out a tomography, to examine blood and urine. Self-medication is prohibited, as this can cause serious complications. Although a closed pertrochanteric hip fracture is not life-threatening, it is important to start treatment promptly.
Main types of fractures
Transtrochanteric and intertrochanteric fractures may appear identically. However, they are divided into several types. Among the main types of damage in this area of the human skeleton are:
- Strochanteric fracture of the diaphysis with displacement.
- Intertrochanteric with hammering (no offset).
- Intertrochanteric without hammering (displacement detected).
- Through trochanteric (no gouging or displacement detected).
- Spiral.
- Closed pertrochanteric fracture of the femur.
The specific type of fracture can only be identified after careful medical examination.
How to eat during the recovery period?
Most often, fractures require long-term therapy, during which it is important to follow a rational diet. After injury, a zone of increased pressure is formed, as a result of which cells die, where the metabolic process is activated. For this reason, the body needs a certain number of useful elements and vitamins.
With a fracture, you need to eat a balanced diet. The diet should includesufficient amount of proteins, fats and carbohydrates. It is necessary to focus on those foods that contain more protein. Easily digestible food should be consumed. In order not to disrupt the functioning of the gastrointestinal tract, it is recommended to eat food in small portions.
Thanks to this, the process of bone tissue regeneration will be accelerated and the process of absorption of useful elements into the intestines will be normalized. With the help of ascorbic acid and tocopherol, the general well-being of the patient can be improved, since they are able to reduce the activity of lipid peroxidation. Eat more foods that contain calcium (dairy products and fish).
He althy food will saturate the body with vitamins and improve the general well-being of the patient. It will speed up the healing process and the taste quality of food, which plays an equally important role. Since the patient enjoys chewing, the whole body is regenerated and the patient recovers in the shortest possible time.
It is important not to overload the work of the gastrointestinal tract with hard-to-digest ingredients. Recommended foods include: turkey, beef, cod, trout, cereals, dairy products, vegetables, fruits, beans, peas, broccoli, currants, turnips, olives, radishes. It is necessary to discuss in detail the nutrition menu after the operation. A trochanteric fracture is a pathology that must be treated comprehensively under the strict supervision of a physician.
