Aetiology
A fracture of the neck of the femur is typically caused by a fall onto the side of the hip or a direct blow to the area. It is more common in elderly patients, due to age-related weakening of the bone.
Diagnosis
The diagnosis is usually made by a combination of physical examination, imaging studies, and laboratory tests. Physical examination may reveal tenderness to palpation, deformity, and limited range of motion. Imaging studies such as X-rays and CT scans are used to confirm the diagnosis and assess the location and type of fracture. Laboratory tests such as a complete blood count, erythrocyte sedimentation rate, and C-reactive protein may be done to assess for infection or other underlying medical conditions that may be contributing to the fracture.
Differential diagnosis
The differential diagnosis for a fracture of the neck of the femur includes other fractures of the hip, such as intertrochanteric and subtrochanteric fractures, as well as conditions such as osteoarthritis and avascular necrosis.
Treatment
Treatment depends on the type and severity of the fracture, as well as the patient’s overall health and age. Non-surgical treatments such as bracing, bed rest, and physical therapy are usually sufficient for less severe fractures. Surgery may be required for more severe fractures, such as those involving multiple fragments or displacement. Surgery may involve open reduction and internal fixation with screws and plates, or total hip replacement.
Prognosis
The prognosis for a fracture of the neck of the femur is generally good if the fracture is treated promptly and appropriately. Most patients are able to return to their normal activities within 6-12 weeks after a successful treatment. Complications such as non-union, infection, avascular necrosis, or malunion can occur if the fracture is not treated properly.