Neck of femur fracture natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
If left untreated, 30% of patients with neck of femur fracture may progress to develop non union and avascular necrosis. Common complications of neck of femur fracture include infections and thromboembolism. Prognosis is generally poor, and the 1 year mortality rate of patients with neck of femur fracture is approximately 25-30%.
Natural History, Complications, and Prognosis
Natural History
- If left untreated, 30% of patients with neck of femur fracture may progress to develop non union and avascular necrosis of head of femur.[1][2]
Complications
- Common complications of neck of femur fracture include:[3][4]
- Nonunion
- Varus malreduction most likely leads to non union.
- Infection
- Chronic pain
- Dislocation
- Avascular necrosis (AVN)
- Posttraumatic arthritis
- Complications Of Prolonged Recumbency such as:
- Hypostatic pneumonia
- Pressure sores
- Deep venous thrombosis
- Pulmonary embolism
- Cardiac failure due to weakening of the cardiac muscle and poor venous return
- Muscle wasting
- Common peroneal nerve palsy
- Stiffening of joints
- Osteoporosis
- Urinary tract infections
- Depression
- Nonunion
Prognosis
- Prognosis is generally poor, and the 1 year mortality rate of patients with neck of femur fracture is approximately 25-30%.[5][6][7][4]
References
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Moulton LS, Green NL, Sudahar T, Makwana NK, Whittaker JP (2015). "Outcome after conservatively managed intracapsular fractures of the femoral neck". Ann R Coll Surg Engl. 97 (4): 279–82. doi:10.1308/003588415X14181254788809. PMC 4473865. PMID 26263935.
- ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.
- ↑ 4.0 4.1 Faraj AA (2008). "Non-operative treatment of elderly patients with femoral neck fracture". Acta Orthop Belg. 74 (5): 627–9. PMID 19058696.
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Marshall T, Suthersan M, Chan MK, Jenkins B, Toh M, Giddins V; et al. (2016). "Mortality and morbidity of neck of femur fractures: A comparison between Orange and peripheral centres". Aust J Rural Health. 24 (4): 253–7. doi:10.1111/ajr.12255. PMID 26691875.
- ↑ Sheikh HQ, Hossain FS, Aqil A, Akinbamijo B, Mushtaq V, Kapoor H (2017). "A Comprehensive Analysis of the Causes and Predictors of 30-Day Mortality Following Hip Fracture Surgery". Clin Orthop Surg. 9 (1): 10–18. doi:10.4055/cios.2017.9.1.10. PMC 5334018. PMID 28261422.