Femoral neck fracture

Comprehensive assessment - professional treatment

A femoral neck fracture is an injury typically sustained by older people. It causes immediate immobility and almost always requires surgical treatment. Most fractures occur in people over the age of 70. In the majority of cases, patients have a number of significant co-morbidities that can often be one of the causes of the fall. Women are affected around three times as frequently as men.

Our specialists at Schoen Clinic have many years of experience in the surgical treatment of femoral neck fractures. We always take account of the patient's overall health situation, particularly in older individuals. Our aim is the complete restoration of your mobility.

Causes & symptoms

What is a femoral neck fracture?

A distinction is essentially made between 
  • Femoral neck fractures
    The cause of this is usually a fall onto the hip. As a result of this, the head of the femur breaks off from the neck of the femur. In older people, this type of fracture is usually treated with a joint replacement. Younger patients may be treated with a screw fixation.  
  • "Pertrochanteric" femoral neck fractures
    In this case, the fracture site is slightly further away from the head of the femur, so the fracture is positioned further outwards. The cause of this is usually a heavy fall. The majority of these injuries are stabilised at Schoen Clinic using nails.

Both types occur with approximately equal frequency.

Causes: How a femoral neck fracture develops

In older people, the most common cause of a femoral neck fracture is a fall onto the hip joint. The injury is usually favoured by osteoporosis, a condition in which the density of the bone is reduced. Compared to the bones of younger people, osteoporotic bones break much more frequently under the same stress. Added to this are further factors such as an unsteady gait, dizziness, heart rhythm disturbances, poor vision or weakness in older patients: these significantly increase the risk of falls.

It is rare for femoral neck fractures close to the hip joint to occur "insidiously" and without trauma. In these cases, marked osteoporosis (bone loss) or bony metastases may be the cause. Poor nutrition due to anorexia can also lead to osteoporosis, however, and therefore to premature fragility of the bones.

Femoral neck fracture – the symptoms: These symptoms may occur

Femoral neck fractures close to the hip joint are easy to recognise. They generally lead to immediate immobility. The affected leg often appears shortened and externally rotated. In cases involving incomplete fractures (fissures) or gradual development without trauma, the symptoms are less clear-cut. In most cases, the patient complains of hip or groin pain when walking. In some cases, the pain is also felt in the knee. 

Diagnostics

Diagnosis: How we diagnose femoral neck fracture

If a femoral neck fracture is suspected, generally X-ray images of the pelvis and affected hip will suffice. If the images are unremarkable but the severe pain persists, then we will carry out an MRI scan of the hip joint. This allows partial fractures or stress fractures of gradual onset to also be diagnosed. While we are performing these investigations, we also carry out screening for osteoporosis.

Skeletal scintigraphy

Sometimes, a femoral neck fracture can also be caused by a tumour. Skeletal scintigraphy can be used to quickly determine whether the tumour involved is isolated or whether there are already other bony metastases present. In certain circumstances, small samples of tissue may also need to be taken for microscopic examination.