A femoral head fracture is what doctors call a fracture of the femoral head. That fracture occurs very rarely; often only in combination with a hip socket fracture or a dislocation of the hip joint. For that fracture to occur, an enormous external force must act. Prevention is usually not possible.
What is a femoral head fracture?
According to abbreviationfinder, the femoral head fracture severely restricts the patient’s movement. In most cases, however, this fracture does not occur alone, but is accompanied by other fractures and injuries to the hip and usually to the entire body.
The femoral head is located at the top of the thigh bone. That is surrounded by the hip socket. The femoral head and the hip socket form the ball and socket joint of the hip. Due to its shape, the ball joint also guarantees the enormous freedom of movement that people enjoy. Because the thigh can very well be moved in all possible directions.
In order for that movement to remain guaranteed, there must be an optimal function between the femoral head and the hip socket, which is also covered with a cartilaginous sliding layer. That can be compared to a shock absorber. The joint capsule seals the connection and subsequently produces fluid, which is necessary for the cartilage to allow smooth movement. According to Pipkin, who classified the femoral head fracture, the fracture is divided into four types – depending on the side effects and location:
- Type I: Here a fracture develops below the so-called foveacapitis femoris; the fracture thus occurs outside the designated stress zone.
- Type II: Fracture of the femoral head occurs above the designated loading zone; the doctor speaks of a fracture that is in combination with the fovea capitis.
- Type III: Sometimes a type I or type II, but in connection with a medial femoral neck fracture.
- Type IV: Type I or Type II associated with a fracture of the acetabulum
Causes
A fracture of the femoral head occurs mainly when there is a tremendous amount of force. Above all, external forces or falls can trigger a corresponding injury. However, femoral head fractures are relatively rare; especially the pure fractures – without combination with a femoral neck fracture or a fracture of the acetabulum – only occur in very few cases.
Symptoms, Ailments & Signs
The patient mainly complains of very severe pain. There is also a restriction of movement that primarily develops on the affected side. In the context of such an injury, the patient can neither walk nor stand. If it is a type III, shortening of the external rotation of the legs can also occur. This shortening is also possible with a type IV injury.
In the context of such a fracture, it is important that immediate medical attention is given. The patient must be treated by a doctor as soon as possible. This is mainly because the person affected not only has to endure enormous pain, but it is also important which therapy the doctor chooses.
This is ultimately responsible for whether and to what extent consequential damage can remain or a 100 percent healing can take place. In almost all cases, surgical treatment is carried out; only in the case of type I injuries can it be assumed that the physician will opt for conservative therapy.
Diagnosis & course of disease
The medic begins with a physical exam. The main focus is on what pain the patient reports and whether there is a restriction in mobility. The physician is also primarily interested in whether the patient fell or whether the violent effect came from outside – for example as a result of a car accident (impact).
X-rays are taken so that the doctor can be sure that the fracture is a femoral head or what type it is. Computed tomography scans can also sometimes be ordered to confirm the injury and type. Normally, however, doctors can already tell from an X-ray that there is a fracture or what type it is.
Complications
The femoral head fracture severely restricts the patient’s movement. In most cases, however, this fracture does not occur alone, but is accompanied by other fractures and injuries to the hip and usually to the entire body. The patient suffers from severe limitations in everyday life.
Often there is also a shortened rotation of the legs, which also has a negative effect on the movement of the person concerned. The femoral head fracture leads to extremely severe and stabbing pain. It is not uncommon for patients to faint immediately after the accident and therefore have to be treated immediately. The pain also occurs in the form of rest pain and can have a negative impact on the patient’s sleep.
There is no guarantee that the patient will be completely cured. In many cases, restricted movement and other symptoms occur even after the treatment. The patient’s resilience is significantly reduced and it is often no longer possible to do any sporting activities.
As a rule, there are no special complications during the treatment itself. This takes place through surgical interventions and alleviates the symptoms. It is not uncommon for prostheses or an artificial joint to be required.
When should you go to the doctor?
Since the femoral head fracture is a broken bone, it must always be examined and treated. It will not heal on its own and will usually fuse incorrectly if this fracture is not treated by a doctor. The doctor should be consulted if there is severe pain in the affected region. The pain is usually associated with restricted mobility. Especially after an accident or after a severe blow, these symptoms can indicate a femoral head fracture and should be examined by a doctor.
In some cases, the pain can be so severe that the sufferer loses consciousness and faints. An ambulance should then be called or the person concerned transported to a hospital. Femoral head fractures are usually treated with surgery. There are no particular complications, so that the life expectancy of the person affected is not negatively affected by the fracture.
Treatment & Therapy
Which therapy is chosen depends above all on the location of the fracture, what side effects have been identified and how old the patient is. If there is a type I fracture, the femoral head is reduced. In the process, an exact adaptation of the fragments is created. This is a classic conservative therapy. In most cases, Type I fractures do not require surgery.
In type II, on the other hand, a supply is carried out using screws. The doctor speaks of an osteosynthetic screw connection; the femoral head is reinforced with screws. That therapy can only be done surgically.
In the case of type III or IV fractures, the age of the patient plays an important role. If possible, younger patients are treated with what is known as osteosynthetic treatment. In older patients, a hip joint endoprosthesis is usually used. This should also subsequently resolve any persistent complaints that may have arisen as part of the accident.
Above all, the hip joint endoprosthesis – in older patients – has ensured successful therapies. It is important that – no matter what type of patient is diagnosed – physiotherapy is carried out so that on the one hand the femur can be strengthened and on the other hand any mobility restrictions can be prevented.
Prevention
A femoral head fracture cannot be prevented. Since that injury occurs as part of an accident, it can only be said that caution is required and falls should be avoided. There is no recipe for how to prevent a corresponding fracture.
Aftercare
Accidents and enormous acts of violence are the causative factors in femoral head fractures. They appear purely by accident. Unlike in the case of tumor diseases, follow-up care cannot prevent the symptoms from reappearing. Early diagnosis is not an option due to the acute trigger. Nevertheless, scheduled follow-up examinations are necessary.
The therapeutic framework gives reason for this. Older people in particular often need long-term treatment due to their reduced physical regenerative capacity. The aftercare mainly includes physiotherapy. In the exercise units, the muscles are strengthened and mobility restrictions are eliminated. This is followed by self-responsible regeneration units at home.
Follow-up care generally includes mandatory appointments in which the progression of the disease is analyzed. Such a procedure is also indicated for a femoral head fracture. Doctor and patient agree on an individual rhythm that corresponds to the complaint situation. In addition to a detailed physical examination, imaging methods are important in assessing the course of the disease.
X-rays in particular, but also computed tomography, guarantee a clear diagnosis. The motor skills and blood circulation are also assessed by the doctor. The detailed nature of the survey is based on the fact that a femoral head fracture can develop into arthrosis. This unfavorable complication must be avoided in any case.
You can do that yourself
In the case of a femoral head fracture, the patient tries to improve the chances of success of the surgical intervention with supportive measures. Immediately after the operation, the patient is required to remain in a resting position and to avoid straining the hips and the entire musculoskeletal system. During this phase, the patient is usually closely monitored by the doctor, and the person concerned must follow all the advice of the doctor and nurses. Stress and excitement should be avoided, and a healthy diet will help the body recover after surgery.
As soon as the patient returns to his usual living environment after inpatient treatment, he continues to take his restricted mobility into account. The person affected avoids excessive physical stress and allows themselves sufficient rest to promote healing. He also pays attention to adequate wound care and gets the help of other people for physically demanding activities. Unpleasant after-effects of the operation in the hip area can be alleviated by means of medically recommended ointments and painkillers.
Physiotherapeutic treatment usually follows to restore mobility, whereby the patient has a positive influence on the chances of recovery by regularly carrying out the prescribed exercises at home. Additional exercise units are often possible, which must be coordinated with the therapist in any case.
