hip fracture - Causes, Symptoms and Treatment .MF .
According to the literature fractures of the proximal femur occur in every eighth case of damage to bones and is 68% of all fractures of the femur.At the same time, patients aged over 60 years are found in 68-80 cases out of 100.
structure of the femur and the hip joint:
Femur - big and long bones in the human structure.
- two ends (epiphysis).
upper epiphysis ends the round head of the femur, which is connected to the hip bone.
body femur connects to the femoral head, using the narrowed part of the neck.
In connection zone neck of the femur and the body are two powerful bony prominences:
- greater trochanter of the neck.
- lesser trochanter at the lower edge of the neck.
Skewers connected intertrochanteric line and the intertrochanteric crest.
hip joint - has a cup-like shape formed by the acetabulum of the pelvic bone and the femoral head.Inside the joint is the round ligament of the femoral head, which are the blood vessels and nerves to the head of the femur.
All types of fractures in the majority of cases occur in the elderly and are usually formed in the fall.
Symptoms of fractures of the femoral neck
- The first symptom - a pain in the groin, it focuses not sharp, but the pain becomes stronger when you try to move.The pain also increases, if you try to knock a light tapping on the foot heel.
- second symptom - a broken leg slightly turned outwards.This can be seen on foot.
- third symptom -. Shortening, about 2 to 4 cm This symptom occurs because the bone is broken, and the muscles, contracting, tighten the leg closer to the pelvis.
Also there are fractures in which patients can go several days or even weeks.
Diagnostics for fractures of the femoral neck
Diagnostics for fractures of the femoral neck, usually is not difficult.The diagnosis becomes clear during clinical examination.The patient complains of in the field of hip pain.The injured limb is shortened, it rotated outwards, the patient can not tear the heel off the bed.And all this is usually confirmed when the X-ray.
First aid for fractures of the femoral neck
- lay the victim on his back.
- fix foot bus, always with the capture of the knee and hip joints.
deliver in a medical facility.
Treatment perlomov hip
unfavorable conditions for the seam due to local anatomical features and the difficulty of immobilization (providing stillness).Bone fracture healing occurs within 6-8 months.At the same time, prolonged bed rest in the elderly leads to the development of congestive pneumonia, pressure sores, thromboembolism, which is the main cause of high mortality.Therefore, methods of treatment, associated with prolonged immobilization of the patient, the elderly should not be applied.Skeletal traction and plaster bandage hip as independent treatments are currently not used.
Under these fractures of the femoral neck in the most rational surgery.In cases where surgery is contraindicated have resorted to a conservative, more functional treatment, which is an early activation of the patient.When conservative treatment, often to achieve a breakthrough fusion fails.The purpose of this method - saving a patient's life.
operation is performed on urgent indications.
for osteosynthesis (bone regeneration) are most commonly used three titanium screws.
In elderly patients with fractures of the femoral head is not expedient to carry out fracture osteosynthesis and joint replacement with an artificial one.arthroplasty for fractures of the femoral neck in patients older than 70 years is becoming more common.The advantage of it is the possibility of early loading on the operated limb (2-3 months, and in cases of bone cement to fix the prosthesis to the limb femur load possible from the very first days after the operation), which is essential for patients with weakened elderly.
forecast using surgical treatment in respect of life is favorable.When conservative methods of treatment, mortality reaches 50-70%.
Care of patients with fractures of the femoral neck in
When caring for patients with fractures of the femoral neck, a number of problems to be solved.The first of them - it's a pain in the groin and leg.She is not strong, but it brings with it discomfort and, as a consequence, a violation of the psychological contact with a person - it is difficult to communicate with him.
One of the major problems - bedsores.These people, they occur mainly in the sacrum and on the heel sore feet.
Due to the fact that the sacrum is constantly in contact with the bed, and the skin moisturized to prevent diaper rash it must necessarily apply podsushivayuschee ointment or dusting powder (talc for the body, zinc ointment).It is important to frequently change clothes, under the sacrum - diapers.
Effective massage: it helps to cope with the stagnation of blood in the affected leg, which leads to increased pain.It is best to do a light stroking massage of the feet to the body.It should also develop tools to help you at least raise the pelvis on the bed, giving the sacrum rest, if it is impossible to turn on its side.
All the patients for a long time are lying down, suffering intestinal, which are the result of constipation.This problem is difficult to handle, because pain, on the one hand, prevents the active movement and, on the other hand, a negative effect on appetite - the patient eats small, and had constipation occur.Pain on the delay of the chair aggravates the pain from the fracture.Constipation - a very big problem for those who broke her hip.Prevention is better to start at once, from the first hour, from day one.To do this, use products that cause increased peristalsis.A good result gives a welcome sunflower oil, the use of dairy products.Various means can be used to stimulate the motility such gutalaks drops.
Long stay in the supine position leads to another serious complication - pneumonia, mostly, of course, the old people.This is a fairly common complication and requires active employment breathing exercises.
external rotation of the foot - the next problem.If over time the patient is able to stand up and even walk after a hip fracture, is inverted as a result of rotation of the foot will interfere with walking.Under knee should enclose derotation roller.
observed mental problems.Some elderly people will develop dementia, ie senile dementia.Pain, limited space, the decline of their own opportunities - all contribute to the exacerbation of mental illness.May develop depression, mainly in those with normal consciousness.Characteristically feeling of depression.Assistance in such cases is to create a familiar, comfortable environment, establishing the maximum communication with the patient.
To avoid most of the problems described above, with the first days of the patient's need to sit up in bed.From the early days to get up and stand next to the bed with the help of a chair, Walker - the walker, crutches.From the first days of the need to slowly move around with a walker without reliance on the injured leg.