The hip joint. Fractures of the femoral neck

June 4, 2013

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The hip joint It is one of the largest joint in the human body. It forms the acetabulum of the pelvic bone and the femoral head. At the edge of the acetabulum have hryascheobraznaya fabric and covers the joint capsule, strengthens ligaments. Muscles cover the joint on all sides.

Fracture of the femoral neck often occurs in people who have reached old age. Approximately 90% of such trauma occurs in older people, and, more often suffer from this woman in years menopause . Hip fractures in the elderly leads to the fact that the patient is undergoing treatment for several months, a long time forced to comply with bed rest. In addition, after such a trauma patient developed serious complications that about a third of cases completed deaths in the first year after the fracture.

How is a hip fracture?

Usually, hip fracture   It occurs in humans due to an injury sustained at the time of falling sideways. This is the hardest injured on the hip. But the consequences of such a fall is not always expressed such a fracture. This causes injury and the presence of other causes, since the joint is nevertheless designed for high loads.

At the same time while you exercise hard to break the neck of the femur. Consequently, such a trauma in young people is observed only in very rare cases, when it comes to accidents, serious falls, etc.

Hip fractures person most often occurs in people suffering osteoporosis . This disease leads to the fact that the patient is gradually washed away from the body calcium salt , Which is responsible for bone strength. Osteoporosis in humans is due to several reasons. This, above all, is too low intake of calcium in the body is either very high consumption of that element. In addition, osteoporosis - a frequent companion of women, whose age is close to post-menopausal. It was during this period of life as a result of hormonal imbalance intensifies the process of leaching of calcium from bone tissue. According to medical statistics, osteoporosis is diagnosed in half of the women who have attained 50 years of age.

Symptoms

After hip fracture in men first feels pain in groin area. These symptoms tend to become more pronounced when the injured person starts to move. Sometimes, the pain is not strong, so people will be able initially simply do not pay attention to it. As a result, a person may refuse medical help, not counting a serious injury.

Outwardly manifested symptoms of the fracture that is noticeable outward rotation of the foot, where there was a fracture of the femoral neck. This is easily determined by the unnatural rotation of the foot. In addition, the affected leg becomes shorter by a few centimeters (usually 2-3 cm). This phenomenon - the result of the contraction of muscles that occurs after injury. Therefore, the diagnosis of the doctor examines the patient in the supine position and notes that the foot becomes shorter.

There is another symptom, which is called "symptom stuck heel." The fact that a patient who was a fracture of the femoral neck is not able to tear the heel from the surface on which rests. If you knock on the heel of the affected leg, the pain increases.

First aid for fractures of the femoral neck

The success of treatment depends not only on how well the victim underwent surgery, but also from the first aid provided at a suspected fracture. In addition, important rehabilitation after hip fracture, which is carried out by doctors after the surgery, and proper care of such patients.

But immediately after the injury before the arrival of the first medical aid to the patient are those who dwells with him. Initially, a person should be put in position on the back, secure the bus that leg that suffered. Then you need to call a doctor or bring the victim to a medical facility. Return leg in the correct position without the experts can not in any case.

Types of hip fractures

In modern medicine, the diagnosis of "hip fracture" is put in the three cases. Relatively easy option - a fracture in the area of ​​the greater trochanter, which limits the femur and the neck of the femur. Heavier fracture - in the neck directly, which connects the thigh bone and the femoral head. But the most serious case is considered to be a fracture in the femoral head.

In addition, the closer the head bone fracture occurs, the less likely that the bone srastetsya correctly. The fact that the femoral head is located in a relatively confined space. Therefore fracture often occurs necrosis .

In addition, the classification is determined by the hip fractures at the place of occurrence: they are divided into medial and Lateral . The medial fracture   It occurs in the region where the capsule is attached to the hip joint, and lateral fracture   - In the head region of the femur close to the joint.

Complications

Hip fracture in the elderly is often provokes a variety of complications in the patient. The most frequent complication - it bedsores Which are shown on the body of the sacrum and buttocks. The fact that the patient after the operation remains very long period in the state of bed rest. As a result, the soft tissues are compressed, and is a violation of blood flow. Later produced tissue necrosis, which is called bedsores.

Due to the long period of immobility of the patient may receive another serious complication - deep vein thrombosis leg .

Elderly people after hip fracture often ill hypodynamic congestive pneumonia . This form of pneumonia is very difficult to antibiotic therapy, and may ultimately lead to   respiratory and   cardiovascular disease . The consequence of such serious diseases can be fatal.

Besides these complications of prolonged immobility of the body can lead to disruption of normal motor functions of the human intestine. The consequence of this are chronic constipation . In turn, prolonged constipation lead to severe intoxication.

Another category of complications - psycho-emotional disorders. Such patients tend tearfulness, irritable, sometimes they manifest depression .

Treatment

How to treat a hip fracture, orthopedic specialist determines, taking into account the individual characteristics of the injury, the patient's health, the presence of other diseases.

Note that if the patient vnutrikapsuklnogo fracture   possibly injured joint bone fragments (called impacted fracture ). This situation - the way to the development of avascular necrosis, so it is imperative to carry out surgical treatment with the aim of arthroplasty   hip. After this operation, the patient recovers relatively quickly, and within a few days he prescribed physical therapy sessions. Endoprosthesis has several other advantages. So, almost immediately after the surgery a person can move the injured leg. After a few days he was walking with support.

Carrying out how total   prosthetics (total joint replacement is carried out), and SSB (head of the joint being replaced). In the case of hip replacement complications are very rare - in 5-15% of cases. As a rule, the essence of these complications is the need to correct the wrong chosen prosthesis. Stitches are removed after surgery in 7-10 days.

The rehabilitation period (over 3 months) need to strictly adhere to the doctor's recommendations. It is important to engage in physical therapy, to limit the load on the leg, right leg put in a prone position, sitting.

If a patient is diagnosed   vnekapsulny fracture , In this case, surgical treatment is to perform osteosynthesis. The essence of such an operation - fixing the fracture with a metal pin. This intervention provides an opportunity to significantly reduce the period of bed rest, and, therefore, less likely to develop complications. When oseosinteze recovery period lasts about 4-5 months. This method still is not completely reliable, because there is always a risk that the bones do not grow together. Therefore, fixation is not administered to patients who are over 60 years old.

Practice and conservative treatment of fractures. They should be used, if an elderly patient has a number of comorbidities. Given the age of the patient, doctors may doubt the success of such an operation, so decide on a conservative therapy. Such treatment is to provide a state of immobility or skeletal traction injured limb. Such treatment may fracture grow together, not earlier than after 6-8 months after the treatment was initiated.

During this period it is important that people are very strictly adhered to bed rest. Therefore, careful care of this patient. You should always keep in mind the negative effects of a prolonged period of immobility, which are expressed in the formation of bedsores and other complications. It is necessary to take into account the fact that the elderly man a fracture heals much longer than in younger patients.

Prevention

To reduce the risk of hip fractures, it is necessary to adhere to the recommendations for the prevention of osteoporosis. In addition, it is important to treat this disease, when it has had time to develop, and to try to prevent a fall.

To reduce the risk of osteoporosis, should lead an active lifestyle and regularly give the body weight load. It is useful to run, to dance, to walk a lot. The daily diet should be a lot of foods containing calcium and Vitamin D . Smoking provokes the loss of calcium, so it is desirable to give up the habit, and to minimize the consumption of alcoholic beverages.

To prevent falls, especially when it comes to the old man, it is important to remove uncomfortable mats and furniture, which can meet on its path. It should regularly monitor the visual acuity of an elderly person and to control its overall health. It is particularly important to control the movement of an elderly man during the ice. His shoes should be as comfortable and not slippery.