Source: Healio
Key takeaways:
- Both fracture and patient factors should be evaluated to determine the best treatment for femoral neck fractures.
- Patients with femoral neck fractures should be up and moving as soon as possible after surgery.
In the United States, hip fractures occur in about 300,000 people per year, according to the CDC, of which 50% are classified as femoral neck fractures.
While femoral neck fractures can be caused by high-energy trauma, such as car accidents, these injuries are often caused by low-energy injuries in older patient populations. Because of this, the rate of femoral neck fractures is predicted to increase as the population ages.
“As we age, our bone density gets worse, our balance gets worse and we are at increased risk for falling,” Robert T. Trousdale, MD, professor of orthopedic surgery at the Mayo Clinic in Rochester, Minnesota, told Healio. “As there are more people at risk for falling with poor bone, the number of patients who have femoral neck fracture has certainly increased within the last 3 decades just because of demographics.”
While femoral neck fractures have been traditionally treated with internal fixation, Joseph T. Patterson, MD, associate professor and clinical scholar at Keck Medicine of the University of Southern California, said this yielded high complication rates.
“Maybe 30% of these older adults with a displaced femoral neck fracture need another operation after internal fixation,” Patterson said. “It is especially true that the older the patient is, the worse the bone quality is. The screws do not get good fixation. That is a problem because these older adults are the patients who do better if we get them up and get them walking and moving.”
Because of these complication rates, Patterson said there was a shift from fracture fixation to hip replacement, whether through a hemiarthroplasty or a total hip arthroplasty.
Even with the option of partial or total replacement available, the answer of whether to perform fixation or replacement is still not cut and dry, according to Trousdale.
