Neck of femur fracture medical therapy: Difference between revisions
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{Neck of femur fracture}} | {{Neck of femur fracture}} | ||
{{CMG}}; {{AE}} {{Rohan}} | {{CMG}}; {{AE}} {{Rohan}} | ||
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==Medical Therapy== | ==Medical Therapy== | ||
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[[File:Derotational boot.JPG|400px|thumb|Conservative management with derotational cast [https://upload.wikimedia.org/wikipedia/commons/2/22/Bullous_pemphgoid_in_a_72_year_old_bedridden_female3.JPG Source: Case courtesy of Ashashyou [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons]]] | |||
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The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.<ref name="pmid19058696">{{cite journal| author=Faraj AA| title=Non-operative treatment of elderly patients with femoral neck fracture. | journal=Acta Orthop Belg | year= 2008 | volume= 74 | issue= 5 | pages= 627-9 | pmid=19058696 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19058696 }} </ref><ref name="pmid26263935">{{cite journal| author=Moulton LS, Green NL, Sudahar T, Makwana NK, Whittaker JP| title=Outcome after conservatively managed intracapsular fractures of the femoral neck. | journal=Ann R Coll Surg Engl | year= 2015 | volume= 97 | issue= 4 | pages= 279-82 | pmid=26263935 | doi=10.1308/003588415X14181254788809 | pmc=4473865 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26263935 }} </ref><ref name="pmid18646065">{{cite journal| author=Handoll HH, Parker MJ| title=Conservative versus operative treatment for hip fractures in adults. | journal=Cochrane Database Syst Rev | year= 2008 | volume= | issue= 3 | pages= CD000337 | pmid=18646065 | doi=10.1002/14651858.CD000337.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18646065 }} </ref><ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref> | The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.<ref name="pmid19058696">{{cite journal| author=Faraj AA| title=Non-operative treatment of elderly patients with femoral neck fracture. | journal=Acta Orthop Belg | year= 2008 | volume= 74 | issue= 5 | pages= 627-9 | pmid=19058696 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19058696 }} </ref><ref name="pmid26263935">{{cite journal| author=Moulton LS, Green NL, Sudahar T, Makwana NK, Whittaker JP| title=Outcome after conservatively managed intracapsular fractures of the femoral neck. | journal=Ann R Coll Surg Engl | year= 2015 | volume= 97 | issue= 4 | pages= 279-82 | pmid=26263935 | doi=10.1308/003588415X14181254788809 | pmc=4473865 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26263935 }} </ref><ref name="pmid18646065">{{cite journal| author=Handoll HH, Parker MJ| title=Conservative versus operative treatment for hip fractures in adults. | journal=Cochrane Database Syst Rev | year= 2008 | volume= | issue= 3 | pages= CD000337 | pmid=18646065 | doi=10.1002/14651858.CD000337.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18646065 }} </ref><ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref> | ||
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'''Indications''' | '''Indications''' | ||
*Non-ambulators | *Non-ambulators | ||
*Patients with minimal pain | *Patients with minimal [[pain]] | ||
*Patients who are at high risk for surgical intervention | *Patients who are at high risk for surgical intervention | ||
'''Techniques''' | '''Techniques''' | ||
*Derotational cast | *Derotational [[Cast (orthopedic)|cast]] | ||
*Traction | *[[Traction (orthopedics)|Traction]] | ||
===Complications=== | ===Complications=== | ||
*Osteonecrosis | *[[Osteonecrosis]] | ||
*Non union | *Non union | ||
*Complications Of Prolonged Recumbency such as: | *Complications Of Prolonged Recumbency such as: | ||
**Hypostatic pneumonia | **Hypostatic [[pneumonia]] | ||
**Pressure sores | **[[Pressure sores]] | ||
**Deep venous thrombosis | **[[Deep vein thrombosis|Deep venous thrombosis]] | ||
**Pulmonary embolism | **[[Pulmonary embolism]] | ||
**Cardiac failure due to weakening of the cardiac muscle and poor venous return | **[[Cardiac failure]] due to weakening of the [[cardiac muscle]] and poor [[venous return]] | ||
**Muscle wasting | **[[Muscle wasting]] | ||
**Common peroneal nerve palsy | **Common [[peroneal nerve]] palsy | ||
**Stiffening of joints | **Stiffening of joints | ||
**Osteoporosis | **[[Osteoporosis]] | ||
**Urinary tract infections | **[[Urinary tract infections]] | ||
**Depression | **[[Depression]] | ||
==References== | ==References== | ||
Latest revision as of 18:27, 29 April 2019
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Neck of femur fracture medical therapy On the Web |
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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
The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.
Medical Therapy
 |
The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.[1][2][3][4][5]
Non-operative Treatment
Indications
- Non-ambulators
- Patients with minimal pain
- Patients who are at high risk for surgical intervention
Techniques
Complications
- Osteonecrosis
- Non union
- 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
References
- ↑ Faraj AA (2008). "Non-operative treatment of elderly patients with femoral neck fracture". Acta Orthop Belg. 74 (5): 627–9. PMID 19058696.
- ↑ 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.
- ↑ Handoll HH, Parker MJ (2008). "Conservative versus operative treatment for hip fractures in adults". Cochrane Database Syst Rev (3): CD000337. doi:10.1002/14651858.CD000337.pub2. PMID 18646065.
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.