Fracture of the neck of the hip joint is considered to be a severe and fairly frequent injury to the musculoskeletal system. This is rare at a young age. The fact is that this requires a rather strong blow - a fall from a height or a serious injury received, for example, in a traffic accident.
A completely different picture is observed in elderly people. Over the years, bone strength decreases significantly. The reason for this is osteoporosis, in which their thinning and rarefaction occurs. Bones become brittle and brittle.
Disease clinic
Hard to tolerate a fracture of the femoral neck in old age. The consequences can be of the most unpredictable nature - lead to disability or even death. Fractures are divided into three types:
- in the area of the femoral neck;
- in the area of the femoral head;
- near the greater trochanter.
Also divided into:
- median (medial) - intra-articular fracture;
- lateral (lateral) - extra-articular fractures;
- Fractures in the trochanteric region, which are common in older people even with moderate trauma.
Symptoms
Fracture of the femoral neck in old age - the consequences of injuries, infections of bone tissue, malignant or benign bone tumors. The lesion manifests itself with pronounced symptoms:
- Moderate pain concentrated in the groin increases with minor blows to the heel from the side of the possible injury.
- The broken leg is twisted slightly outward unnaturally.
- There is a shortening of the broken leg - the damaged bone allows the muscles to pull the limb closer to the thigh.
- Symptom of "stuck heel" - with a possible flexion-extensor movement, it is impossible to support the straightened leg on the weight.
If a patient has received a fracture of the femoral neck in old age, the consequences of this are primarily detrimental to his psycho-emotional state. Nervousness, capriciousness, frequent mood swings appear. First of all, because of the forced immobility. Immediately problems arise that require endurance and patience.
Treatment
The probability of self-fusion of bones is very small, primarily due to the structural features of the femoral neck and its blood supply. Therefore, it is very difficult to treat a fracture of the femoral neck in old age (it is impossible to predict the consequences of possible complications). In many countries, this issue is solved radically - through surgical intervention.
1. Fixation of fragments of the femoral neck with cannulated screws - osteosynthesis. Complete freedom of movement (on your own) after the operation is possible after four months. But even with this method there are failures. Due to the non-union of the bones, there is a high probability of the formation of a false joint.
How to treat a hip fracture depends on many factors. The older the patient and the longer the time since the injury, the greater the risk of failure. The optimal age of the patient in this case is up to 60 years.
2. Replacement of the hip joint with an artificial joint - arthroplasty.
The optimal age of the patient is from 60 to 80 years. After confirming the diagnosis of "fracture of the femoral neck", the treatment, operation (how it is carried out) is determined by the doctor, taking into account the individual and age characteristics of the patient.
3. Non-surgical conservative treatment is prescribed for patients with multiple concomitant diseases, who have contraindications (heart disease, diabetes mellitus), and those who have practically no chance of successfully undergoing surgery.
This is what we said about the official side. But the long-term practice of treating such fractures has shown that no conservative treatment will help if a hip fracture occurs in old age, the consequences will still lead to death. Doctors were forced to go to the trick and use the tactics of "white lie". Patients were told that there was no fracture, only a severe bruise. Prescribed painkillerspreparations, for fixing the outer foot, a splint made of plaster or an orthopedic boot was applied. But the main emphasis was on the need for active movement, which is an excellent and most important prevention of the consequences:
- Decubitus ulcers.
- Impaired pulmonary blood flow, which inevitably leads to pneumonia.
- Inactivity, which negatively affects bowel function and causes constipation.
- The lack of stress on the caviar muscles causes a violation of venous circulation, which will lead to thrombosis of the veins of the lower extremities.
- Asthenic syndrome. After two months of bed rest, the patient's physical weakness is so pronounced that he can not only walk, but also sit up.
As soon as the pain subsides a little, the patient is allowed to sit with his legs down from the bed. After two weeks, you can stand with a walker or crutches. After three weeks, you should move around as much as possible, leaning on something.
The method of such treatment is not aimed at ensuring the fusion of the fracture - at this age it is simply impossible, but at adapting the patient and teaching him to live with such damage.
Surprisingly, it was this position that allowed many patients to live and be active. The tactics of early activity of patients today is generally recognized.
