What is a Fractured Neck of Femur?
The hip is a ball and socket joint, where the convex head of the femur is held firmly in the concave recess of the pelvis. Cartilage lying between and wrapped around the meeting bone surfaces facilitates smooth movements and creates suction holding the joint in place. These features combined with h2 overlapping ligaments and muscle make the hip a very stable joint.
Below the head of the Femur the bone narrows forming a short neck before it widens again forming a thick bony process called the Greater Trochanter. The length of the Femur then flows straight downward, with the femoral head angled toward the hip socket at approximately 50° off vertical. The shape and structure of the Femur places the greatest stress on the neck of the Femur during general activity. It is the most common site for hip fractures and they can vary in severity for partial micro fractures to complete breaks.
Hip fractures can have a particularly devastating effect on the elderly, not just from the traumatic injury itself, but also from loss of mobility and the capacity to perform daily tasks of living independently.
Above: Assessing biomechanics during a hip fracture
What causes a Fractured Neck of Femur?
Hip fractures amongst young people are uncommon and usually result from a significant trauma, such a motor vehicle crash. As we age the cellular repair of our bones slows down and the supportive muscles and ligaments become weaker and lax, reducing the joints strength and stability. This makes hip fractures amongst the elderly more common and are usually caused from an awkward fall laterally onto the hip. Repetitive strain on the hip joint, with insufficient periods of rest in between, can cause small amounts of damage that accumulate over time and can develop into a stress fracture .
Some conditions like osteoporosis can further weaken the bone structure of the Femur, along with habits like smoking and alcohol intake. Even poor diet can lead to nutritional deficiency in vitamin D, further weakening bone density. Sedentary lifestyles do not put bones under the normal daily pressures that encourage h2er bone growth and older women have a higher fracture risk due to the changing hormone levels.
The specific location of a partial fracture, weather above or below the femoral neck, or the angle of a complete break can vary greatly depending on the specific mechanism of injury and the force that was applied. X-rays will always be necessary to establish the nature of the fracture.
What are the symptoms of a Fractured Neck of Femur?
The symptoms that can present following a fractured neck of Femur will depend on the severity of the break and the associated surrounding tissue damage, such as muscle or ligament injuries . Some common symptoms of fractured neck of Femur include;
- Pain, sharp at the time of injury fading to a persistent dull ache.
- Inability to bear weight through affected hip, due to pain.
- Swelling may be visible compared to other hip.
- Tenderness in the soft tissues over the affected hip.
- Pain worsens when trying to move the affected leg and hip.
- Shorter leg length, if the fracture is complete and displaced upwards.
If the neck of Femur fracture has impeded or damaged any of the surrounding nerves that pass through the joint you could experience some of the following symptoms;
- Loss of sensation in your hip, leg or foot.
- Tingling or pins and needles
- Altered sensation in your leg or foot, such as intense heat or cold.
How is a Fractured Neck of Femur diagnosed?
Above: Following a fracture to the hip, it may be required to patial weight bear with the support from a walking aid.Some hip fractures will seem obvious based on the pain immediately following injury, visible deformation of the hip and inability to bear weight through it. Other partial, micro fractures can cause a dull ache put still allow mobility. If you suspect you have fractured your hip it is important to seek medical attention quickly. A doctor will take a brief subjective history to understand the mechanism of injury before physically assessing you to confirm the presence of a fracture. X-rays are routinely taken to confirm location and severity of any fracture present.
For more information about how Physiotherapy can help treat neck of Femur fractures, or to book yourself an appointment, please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077.
What would a physiotherapy assessment for a Fractured Neck of Femur involve?
If your fracture is a complete break, displaced of potentially unstable it may require surgical intervention to stabilise so that normal healing can begin. If surgically stabilised physiotherapy treatment can begin immediately, otherwise bed rest and maintenance exercises will be necessary until you can achieve mobility without pain. Follow up x-rays will be taken to confirm healing progress and that the fracture site remains stable.
An initial physiotherapy assessment will allow evaluation of your hip to provide the most suitable treatment for you. At Liverpool Physio, your first appointment would be divided into two parts:
Subjective
A conversation between yourself and our physiotherapist to gain an understanding about your lifestyle and what you want to progress back to, the cause of your injury, and your progress since your fracture.
Objective
An assessment of your current pain, range of movement, walking (depending on your weight bearing status), scar (if you have had surgery) and foot/ leg/hip strength.
What would a physiotherapy treatment for a Fractured Neck of Femur involve?
The type of treatment provided will depend on the extent of your injury.
Treatment for non-displaced fractures, that is if the femur has not moved out of place, is usually bed rest and/or use of crutches until passive hip movement is pain free and x-ray films show evidence of bone formation.
If the fracture is displaced (out of place) surgery will be required which involves fixing the bone back in place using pins or screws. Other forms of surgery include a hemi-arthroplasty or half a hip replacement when the head of the thigh bone is removed, and a metal prosthesis is implanted into the joint.
Following your operation you will be seen by a physiotherapist who will help you move your hip and leg and get you out of bed. You may also be provided with a walking aid to ensure you are safe on your feet while you are recovering. Before you are discharged from hospital you will be assessed on the stairs and provided with some exercises to continue with at home.
At Liverpool Physio we provide specialised physiotherapy treatment for people following a fractured neck of femur. It is important to continue physiotherapy treatment following your operation for the best possible recovery.
Physiotherapy treatment at Liverpool Physio will improve your mobility and increase your independence with everyday activities.
Physiotherapy treatment will be individualised and tailored upon your current symptoms and level of function and may include:
- Mobilisation – practising to gradually weight bear on your affected leg as pain allows, to encourage bone healing
- Gait training – helping you to walk better and with more independence
- Practising transfers – get up from sitting, getting on/off the bed, chair, commode
- Practising stairs
- Heat therapy to relax tight and painful muscles
- Muscle strengthening and stretching program for your leg and hip muscles.
- Exercises to improve physical fitness and joint mobility.
- Advise on how to modify activity and when to progress exercises safely.
Your physiotherapist at Liverpool Physio will develop a full treatment plan to suit your individual needs. Physiotherapy treatment at Liverpool Physio will reduce your pain and stiffness and improve muscle strength and flexibility so you can mobilise safely and effectively and return to your everyday activities with confidence and success.
For more information about how Physiotherapy can help treat neck of Femur fractures, or to book yourself an appointment, please email
office@liverpoolphysio.co.uk
or ring us on
0151 558 0077.
How can I arrange a physiotherapy assessment for a Fractured Neck of Femur?
If you are experiencing sharp pain, dull aching or swelling in your hip, and are unable to bear weight through it, you may have a neck of Femur fracture and should seek medical attention. Once diagnosed, weather you require surgical intervention or not, you would benefit from an appointment with one of our experienced physiotherapists to ensure a quicker and fuller recovery.
You can contact us directly to arrange an assessment and we can advise you if further treatment is recommended, or give you details on self-management for minor cases. To arrange an appointment please email office@liverpoolphysio.co.uk or call 0151 558 007I .
Summary
Severe hip fractures can be very painful and prevent any normal mobility of the affected leg until it has been stabilised. Minor cases involving micro fractures may present with symptoms similar to muscle or ligament strains but will require very different treatment. For this reason, it is important that you get your hip assessed as soon as you realise there is a problem.
Whatever the severity of the fracture, if it is treated conservatively or with surgical intervention, early physiotherapy treatment will help you mobilise earlier and achieve a quicker, fuller recovery. We will use a combination of pain relief techniques, stretches and functional exercises to relieve your symptoms and return you confidently to the normal activities of daily living. At Liverpool Physio we will target your personal recovery goals as part of your tailored rehabilitation exercise programme.
For more information about how Physiotherapy can help treat neck of Femur fractures, or to book yourself an appointment, please email office@liverpoolphysio.co.uk or ring us on 0151 558 0077.
↑ Back to top
