Hip trauma is primarily concerned with fractures in the upper extremity of the femur, commonly known as fractures of the neck of femur.
Actually, only the fractures near the head of the femur are strictly speaking fractures of neck of femur. For all other fractures, further from the articulations are strictly spoken fractures of the upper extremity of the femur.
In the vast majority of cases these fractures involve patients over 60 years of age.
Osteoporosis is the mainly the cause.
They often occur after a fall (at home or on public road).
In case of severe osteoporosis (decreasing mechanical skills of the bone) such fracture can occur after mild trauma or even spontaneously.
In France, there are about 100 000 cases of fracture of the upper extremity of the femur or neck of femur per year. With the increasing aging population this number is growing years after years.
The prevention of these fractures becomes a real public health concern. Simple things can have a major impact:
- Eliminate carpets or anything that could be an obstacle on habitual movement in the house.
- Pay special attention to pets, dogs and cats that can cause alders to fall as they get between legs.
- Turn on the light during night movement in the house
- Have his eyesight checked and corrected.
Your GP also has an important role to play in balancing prescriptions of treatments for hypertension or diabetes (thus avoiding discomfort and falls).
Balance disorders should be reported to him to be examined and treated.
Finally, menopausal patients should consult their GP, their rheumatologist or gynecologist to discuss the best treatment of osteoporosis that weakens the bones and thus promotes these femoral fractures but also wrist fractures and vertebral settlements.
If you or one of your loved ones suffers from an upper extremity of the femur fracture, you may be admitted 24/7 in the emergency department of the Francheville Polyclinic.
Our E.R teams are particularly trained in this very common patient support.
Anesthetist’s team intervenes as quickly as possible to reduce pain by regional analgesia techniques while waiting for surgical support.
My concern is to intervene as quickly as possible, as soon as the pre-operative checkup is carried out and the general condition of the patient (s) permits.
The objective is to allow the patient to walk again and to return home as quickly as possible in order to limit the very harmful effects of bed rest and hospitalization.
Fractures close to the articulation (femoral neck) will be treated with a hip prosthesis called “intermediate”.
Upper extremity of femur fractures justify an osteosynthesis, i.e. the bone is preserved by restoring it by means of various implantable devices which, in my practice, are most commonly Gamma nails that I implant by way of minimally invasive process with only three small skin incisions (See X-ray reproduction beside).
Whichever technic is used the priority objective is to allow the patient an immediate resumption of its support and walking. Except in a few complex cases, the physiotherapists have the task of retaking this support within the hours following the intervention.
The future of patients after intervention is organized and anticipated at the earliest stage with the support of the Service manager, Ms Perrier, who works closely with the social worker and of course in connection with the patients and their entourage.
All our team is concerned to promote in the best possible conditions a safe return for at home.
Obviously, regarding patients living alone or isolated, we ensure transfers to the different care or convalescence facilities, depending on the available places.
Minimally invasive surgical techniques and progress in anesthesia have made it possible to improve the prognosis of these fractures in a very important way.
For any question, I remain, as well as my team, at families’ or accompanying persons’ disposal to bring in compliance with the rules of confidentiality and medical secrecy the practical additional information and try to explain in order to reassure.