The femur is the longest and strongest bone in the body. The bone is divided into three main areas: the femoral neck, which is located near the pelvis and serves as part of the hip joint, the body of the bone (shaft), and the distal part, which is part of the knee joint.
Due to its strength, fractures in it usually develop as a result of significant and energy-intensive impact injury such as a car accident. However, femoral neck fractures can also occur in adults, usually over the age of 65, after falling over at home or milder injuries due to bone resorption (osteoporosis), which is more common in the elderly.
When should surgery be performed?
Most hip fractures, whether in the neck, body or the distal part of the bone, require surgical treatment. Repair of femoral neck fractures in adults is usually performed within two days of the injury, in order to reduce the chance of morbidity and concomitant mortality.
Even when it comes to hip fractures, surgery is done in the vast majority of cases within two days of the injury. Until the surgery itself, the treatment involves stretching the skin and leg using a weight, which helps to keep the bone parts close to their anatomical location and reduce the pain.
The course of the surgery
There are many types of fractures in the femur and the course of surgery will be determined depending on the location of the fracture and its severity. However, in most cases, internal fixation is performed, in which the bone parts are affixed to each other in the anatomical (natural) position using pins, plates or metal screws. Some hip fractures require partial or complete joint replacement.
In some cases, external fixation of the bone parts is performed using a frame that surrounds the thigh, and using pins that connect the frame to the bone parts, which are removed after the fracture has healed. The type of anesthesia and the duration of the surgery vary depending on its course and the general medical condition at the time of surgery.
Preparation for surgery
Prior to surgery, you will be thoroughly examined by an orthopedic specialist, to examine your medical record and preliminary tests performed. If the operation is performed under general anesthesia, an anesthesiologist must also perform an evaluation and you should be in full food fast mode according to the staff's instructions.
Recovery after the procedure
After surgery, the patient is to remain in the hospital for several days. In some cases, the leg is placed in a splint or cast after the operation for several weeks, in order to allow it to recover. During this time you may need to use crutches or a wheelchair.
It is important to follow the instructions of the treating staff when it comes to getting back into activity and carrying weight on the leg. Recovery of simple fractures usually takes several weeks, but in complex cases the duration of recovery and return to activity can be up to six months or more.
Your doctor may also recommend physical therapy and rehabilitation, in order to restore muscle strength, flexibility and range of motion.
Possible complications
In addition to the risks associated with anesthesia, surgery to repair a hip fracture includes a number of risks such as bleeding, infection and nerve damage. In rarer cases, a fat embolism can develop (a condition that can occur even without surgery), and sometimes the surgery fails to fully repair the bone, therefore recovery can be delayed. In addition, the metal plates can cause discomfort.
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