Fracture of the femur is mainly a problem of the elderly. Women over 60 are most frequently exposed to hip fracture. They usually have fractures of the proximal part of the femur: the neck and the intertrochanteric area. What are the causes and symptoms of a femur fracture? What is the treatment?

Fracture of the femuris a fracture typical of osteoporosis Women over 60 are most at risk of fracture of the femur (according to data, it happens to every fifth woman over 60) . Fracture of the femur is twice as common in women.

Fracture of the femur - causes

In postmenopausal women, the cause of a hip fracture is a fall, the so-called low-energy fractures - falling from a chair, from your own height. The energy from the fall is additionally combined with the lack of estrogens, which in a few or several years can result in a loss of up to 30%. bone mass. Estrogen deficiency leads to osteoporosis, manifested by bone fracture, which occurs even in the case of a seemingly trivial fall, e.g. from a bed (it is the so-called osteoporotic fracture). Men are less prone to fractures, as the loss of bone mass is much slower, but also occurs!

A fracture of the femur can also be caused by senile infirmity - impaired eyesight, hearing, muscle atrophy, accompanying diseases (e.g. neurological diseases).

Fracture of the femur may also be the result of cancer metastases from the prostate in men, the nipple in women, and the lungs in both sexes.

According to an expert

Author: Łukasz Markiewicz, physiotherapist from the Carolina Medical Center

Łukasz Markiewicz, physiotherapist from Carolina Medical Center

After leaving the hospital, the patient, regardless of the method of surgical treatment used (internal fixation of a fracture or hip joint prosthesis), should be able to move around on crutches or a walker, know basic breathing and anticoagulation exercises.

In the patient's home, you need to install a toilet seat, anti-bedsore mattress, install non-slip and non-slip mats in the bathroom, protect the edges of the carpets so that you do not accidentally trip over when moving.

For 6 weeks, the patient should cool the postoperative area with a coldpack or ice for 15 minutes every 3hours. When lying in bed, the operated limb should be positioned above the line of the heart. He should also wear a compression (anti-clotting) stocking.

The patient can start rehabilitation in the first week after the surgery. If the patient's condition does not allow him to reach the facility, he can start it at home. The goal of home rehabilitation is to become independent in everyday activities - changing positions in bed, sitting down, getting out of bed, walking on crutches, or exercises preparing for walking. up the stairs. In addition, the patient performs isomoteric exercises for the lower limb muscles to prevent muscle atrophy, as well as breathing and anticoagulant exercises.

If the patient is able to reach the rehabilitation facility, in the first weeks, passive exercises are performed to increase the range of motion in the joint, isometric exercises with the help of muscle electrostimulation to prevent muscle atrophy, lymphatic drainage of the lower limb when the patient has swelling of the operated limb.

During a follow-up visit with a doctor, an X-ray is taken, on the basis of which the bone union is determined. If everything heals normally, the patient begins to burden the operated limb to the pain limit. The range of motion in the hip joint also increases. Weight-bearing exercises are introduced, and gait is re-educated (initially on crutches, then without). The muscles responsible for the correct gait stereotype are strengthened.

This will be useful to you

In women over 65, the risk of hip fracture is greater than the risk of heart attack, breast cancer or diabetes, while in men it is greater than the risk of prostate cancer.

Fracture of the femur - symptoms

If the hip bone is fractured:

  • severe pain in the hip and its vicinity
  • the patient is unable to get up from the ground
  • each attempt to move the leg causes additional severe pain
  • the injured leg is usually bent at the hip and the foot is bent outwards

If the fragments are displaced, a slight "shortening" of the leg can also be observed.

Fracture of the femur - research

In the case of a fracture of the femur, an X-ray examination of the bone is performed, and if its result is unclear - a CT scan.

Fracture of the femur - treatment

A hip fracture is an extremely bad fracture with low healing and healing potential. In younger patients with a good biological condition and slight displacement in the joint, vwho have no degenerative changes, an attempt is made to fix them with screws and plates. In the case of non-union and failure of the surgical treatment, an artificial joint is placed - an endoprosthesis.

In the elderly with significant fracture displacement and osteoporosis, the treatment of choice is also an endoprosthesis. Trochanteric fractures (in the bone section between the neck and the shaft) also require rapid surgical treatment, but in this area the potential for fusion is much greater, therefore the primary decisions are made to fix the fractured bones and intramedullary anastomosis or with plates and screws. This area is characterized by good and fast growth, with good prognosis.

Fracture of the femur - treatment after surgery

After surgery, patients should get out of bed as soon as possible, usually the very next day after surgery, mainly to prevent venous thrombosis, pressure ulcers and pulmonary congestion, which can lead to severe pneumonia, walking is started as soon as possible , initially with the help of a walker, sometimes with the prohibition of loading.

It is recommended that you sit down and reposition in bed within 6 hours after surgery. After the surgery, rehabilitation is necessary.

This will be useful to you

A femur fracture is the most severe osteoporotic fracture. 25 percent people return to fitness and walk, 25 percent people die within a year, and 50 percent. people remain dependent or with reduced mobility. The high mortality rate is not due to the fracture but the complications.

The most common are difficult-to-heal pressure ulcers due to prolonged standing still, congestion in the pulmonary circulation and improper ventilation of the lungs favoring infections and inflammations. Surgeries are not high-risk and should be performed as soon as possible, within 24-48 hours after a fracture.

Only then can the patient be rationalized and started quickly. It should be remembered that after such a fracture, treatment of osteoporosis should be started - the low-energy fracture itself allows for the suspicion of osteoporosis.

Category:

Spine, bones, joints