Femoral neck fracture
Revision as of 21:20, 21 July 2016 by Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==")
Background
- Common in older patients with osteoporosis; rarely seen in younger patients
Clinical Features
- Typically minimal bruising (intracapsular)
- If fractured and displaced: externally rotated and shortened
- If non-displaced: patient may be ambulatory
Differential Diagnosis
Femur Fracture Types
Proximal
- Intracapsular
- Extracapsular
Shaft
- Mid-shaft femur fracture (all subtrochanteric)
Evaluation
30% of patients with symptoms suggestive of fracture but negative x-rays have fracture on MRI
- Consider AP pelvis in addition to AP/lateral views to compare contralateral side
- Consider MRI if strong clinical suspicion but negative x-ray
Management
- Ortho consult
- Skeletal traction is contraindicated (may compromise femoral head blood flow)
Disposition
- Admit