Femoral Neck Fractures

By: Bennett Quigley MS, ATC, LAT

Femoral neck fractures are often called Hip Fractures. They are rare overall, but in certain populations it can be a commonplace injury. These injuries tend to have a higher prevalence in the geriatric population, emergency medicine, and younger patients who participate in high-risk impact sports. Osteoporosis can be a contributing factor.

X-ray image of a femoral neck fracture with label and arrow showing the fracture in the boneFemoral Neck Fracture of Femur

Anatomy of A Femoral Neck Fracture

Femoral neck fractures come in many different shapes and sizes. They occur in the femur,, which is the longest and strongest bone in the body.  The femur is also known as the "Thigh Bone". The femoral neck is located at the top of the femur, where it thins to develop the femoral head. The formal head forms the junction of the acetabulum (also known as the hip joint). Fractures tend to form in this area due to the weakened structure of the femur. The bone in this location thins and changes shape to allow articulation with the hip joint. Unfortunately, this causes the bone to be weaker and more prone to fractures. 

Many muscles, ligaments, and tendons originate or insert in this area to allow increased mobility and range of motion for activities of daily living. This means that there is increased force development which can lead to overuse and acute traumatic injuries. 

One area of concern is that the major artery which supplies blood and nutrients to this area passes directly through the hip joint and an injury here can directly affect blood flow to the upper portion of the femur. Therefore, if you suspect an injury to the femoral neck you should contact a specialist immediately for evaluation and continued care.

How Does a Femoral Neck Fracture Happen?

There are a few different mechanisms of injury for femoral neck fractures. In the younger or more “high energy” population it is more common to have fractures present in this area due to excessive impact and force generation. This usually happens when the hip joint is loaded and is forced to abduct (leg moves away from the body). However, in the older population these fractures tend to occur during falls. These falls usually require the foot to be stuck or locked into place with a forcible rotation applied to the hip. Motor vehicle accidents are also a common way to fracture the femoral neck in either population.

Treatment for Femoral Neck Fractures

Treatment for femoral neck fractures usually requires some type of surgical intervention to ensure mobility and function can be maintained. The type of surgery necessary can vary depending on the severity, type of fracture, and age of the patient. 

In younger patients, an Open Reduction Internal Fixation (ORIF) is used with screws or pins through the fracture site to stabilize the area. In older patients, partial or total hip replacements may be considered in order to prevent any need for more surgical intervention later on. 

Recovery time from a hip fracture depends heavily on if surgery is required, type of surgery, and goals for the patient. This can range anywhere from a couple of weeks to a few months. In almost all instances physical therapy will be needed to maintain function and integrity of the hip joint. 

Physical therapy will guide a patient through protected exercises while also working on safe range of motion parameters. Use of anti-gravity treadmill (ie: AlterG) can speed up a person’s return to walking and standing and then eventually running if required.

Related Links:

If you have and injury or possible fracture, the Jacksonville Orthopaedic Institute can help. To schedule an appointment with a JOI Orthopedic Doctor, call (904)JOI-2000, schedule online, or click the link below. To see a JOI Rehab therapist in 1 of our 12 locations, call (904)858-7045.

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