Femoral neck fracture caused by the injury

Femoral neck fracture caused by the injury can be divided into three different situations. (A) of elderly patients Femoral neck fracture more common in elderly patients, mainly due to osteoporosis, bones become extremely fragile small Liang, while the elderly since Xu less capable, slow response, therefore, when subjected to external minor fracture. Most of the damage to life, such as slip or trip the plains Down, from falling on the bed or chairs, and other injuries. It was suggested that the elderly femoral neck fracture prevalence of osteoporosis. Thus have reason to That is a pathological fracture. (B) Green, in their prime Green, Zhuang Nianren general does not exist osteoporosis, the femur bone structure is very strong, need to be more violence in the femoral neck bone Pack. Such as traffic injury or fall injury such as height. Results fracture dislocation which more than obvious that damage blood circulation also heavier, sometimes more than the whole body injury An integral part. As for the fracture of the mechanism, there are two explanations: one is from outside falls directly caused by the other is due to indirect foreign forces As a result of which arrived in the femoral neck after acetabular margin, leverage and because of a fracture. (C) fatigue fracture. Sometimes because of repeated minor trauma fracture occurred gradually accumulated, known as fatigue fracture, such as the marathon or long distance, are likely to march Cause. After characterized by chronic, symptoms not heavy, and new bone fracture line callus at the same time there are often misdiagnosed as hip soft tissue injury. Should Carefully observe x-ray before they can find. More common in blue, their prime. Repeated the role in the ultimate stress fracture of the femoral head can cause, the fact that for Clinical and Experimental Research Institute confirmed. However, its occurrence Mechanism, the changes in the structure of bone, are still not sure. Some people use the crystallization of the molecular structure of the shift to explain, some think that is Because of nutrition centres caused arterial occlusive ischemic bone necrosis was also the result of repeated stress that the bone absorption and speed up the replacement process , Absorb faster than the alternative, which caused the first local osteoporosis. As the last to load and lead to fractures. As fatigue fracture increasingly People know that the trend rate of growth, thus deserves our attention. Categories Femoral neck fractures can be divided into several types, and treatment options and prognosis of a relatively close relationship. (A) of sub-type fracture site 1. The first type Complete fracture of the femoral head, in the femoral neck fractures are far paragraph. Clearly this type of fracture of the blood supply more serious injury. But fracture Reset. Can still maintain a certain stability. Clinical多见. 2. Head and neck - Fracture of the femoral head in part, while another part of the femoral neck, head and neck-it said. The most common is the face of the upper fracture Through the femoral head, and with the bottom part of the femoral neck. Sometimes such as the beak-like. The most common type. As a result of shear stress and stability of the Poor, the stability of fracture reduction also poor. 3. The neck - All fracture of the femoral neck were adopted: in fact. This fracture is rare. Particularly in elderly patients even more rare. Some people have even Put in elderly patients of this type does not exist. The x-ray shows the "neck fracture" is a false impression, often repeated in radiography or reset After the perturbation of films confirmed to-head and neck. (B) the fracture line go genotyping Pauwels in 1935 by the sub-type approach. Mainly based on the fracture line with the inclination to reflect the shear stress suffered by the size of . In line with the femoral fractures vertical line by a point (Linton angle) can be divided into: 30 ° angle of less than those for Type I, the most stable point in 30 ~ 50 ° between those for type Ⅱ, stability times; angle greater than 50 °, for the most volatile type Ⅲ. In practical work experience, the femoral head and neck of femur and the shift rotation, often result in fractures of the Traveling difficult to judge, but only Measurable reduction in before, it was restricted to a certain extent on the application. (C) the extent of the fracture-dislocation Garden in 1961 by the sub-type methods, divided into four types. Type I: incomplete fracture. Ⅱ type: complete fracture, but no dislocation. Ⅲ type: fracture of the dislocation, the femoral head of outreach, femoral neck and mild upward swing. Ⅳ type: fracture completely wrong, obviously on the femoral neck and swing shift. (D) the fracture of the relationship between the type 1. Outward Bound-type A fracture between two of the outreach, the femoral head at a relatively close, the fracture of the distal part of the embedded into the femoral head, the medial No bone dislocation, neck stem angle increases. X-ray film without dislocation and the femoral head spin. Also known as embedded into fractures, location and stability, healing The highest rate. 2. Intermediate X-line from the front view, two fractures of the亦呈outreach embedded into, but x-ray films showed the femoral head flexion, and the formation of the femoral neck A backward point of view, so that the two fractures in the previous paragraph, a separation. Not entirely stable fracture location, as the transition to the resumption of the middle-order Paragraph. 3. Incoming - Two fractures of the completely wrong, the femoral head in the booth, while the femoral neck of the blue on the swing shift, was in close relations, it said, to fracture . Healing the lowest rate. Clinical diagnosis and Femoral neck fracture-dislocation of the blue without difficulties, injury troubles hip pain, can not stand up, show incoming limb, swing and shortening deformity , The DHS upward shift. By tenderness in front of a hip, Kouji DHS or the heel, so that pain can be aggravated. X-through inspection to confirm attendance Off, and further judgement type. We should be wary of are not embedded into the dislocation fractures, are often very mild symptoms, no limb deformities, but the knee in the groin or some Pain, can walk in general, prone to think that soft tissue injury and missed. Such as double-check the hip joint can be found to reduce the scope of activities, in the passive Activities often appeared defensive muscle spasm. Therefore, the elderly hip injury后主v. pain and limited activities, should be thought of femoral neck fracture The possibility, should make the x-ray confirmed. At that time, failed to show such as fractures, but there are still doubters clinical, Zhu Huanzhe bed rest, two weeks after the X-check again, if indeed there are fractures, at this time because of partial fracture of the absorption, the fracture line clearly visible. Factors affecting the healing of fractures Femoral neck fracture after the treatment, should be a concrete analysis of what impact fracture healing factor. Literature review, and by combining our hospital A post-mortem found that the following factors more significant and more consistent views. Understanding of these factors, the choice of treatment, estimated to fracture Whether it has successfully healed, it is necessary to. (A) age Most everyone that the higher the patient's age, fracture healing more difficult. As for the so-called age of the elderly patients, the report abroad Most of the 75-year-old as the standard, such as Brown and other reports: In women over the age of 75 patients, non-union rate of 4 l%. 75-year-old Graham report Buyu rate of over 32 percent, while those under the age of 75 compared to 18 percent. Data show that patients under the age of 70 and their average fracture healing rate of 10 per cent, and each age group there was no significant difference in the age of 70 and above , The Buyu rate as high as 50 percent. The information age are certainly high on fracture healing is a very significant negative factors. Patients should take into account not only the natural age, Patients should take into account the physiological conditions, or the physiological age, in fact some of the older patients did not decline, some patients are Weilaoxianshuai . Therefore, the natural physiological age tend to age more than the actual Significance. (B) treatment time In recent years many tend to be early treatment, and some people even within the femoral neck fracture fixed as emergency surgery. Brown, and other reports 195 cases, within 24 hours of surgery, fracture healing rate was 80%; two days after surgery, the healing rate of less than 50 per cent. At the national level, advocates radical Operation of those rare, in time grasp on a wide. If the Kunisuke, and other reports of 150 cases and found that the surgery within two weeks, healing was no difference between Ho; And two weeks after the surgery, will not increase the healing rate. (C) the extent fracture dislocation The more serious fracture dislocation, the more difficult the healing, which is recognized by all fracture healing the impact of the important factors. If Banks report , The wrong type of fracture healing rate was 72.4 percent; embedded into those type of 96.6 percent, properly handled, up to 100%. Hospital data also showed that: No dislocation and mild dislocation, the healing rate of nearly 100 percent for moderate dislocation, 87.1%; severe dislocation, compared to 67.5 percent. In the judgement of Pack the wrong level, Garden type I and institutions advocating the use of the method is more practical. (D) Posterior bone-crushing side Since 1965 Scheck rear butterfly fracture of the femoral neck by film, the growing importance of this factor. Many of its report in Mechanism and clinical significance of an analysis that Posterior comminuted fracture of the side forward from the angle caused by stress, the collapse of the femoral neck rear emptiness Depression, loss of support, the dumping of the femoral head back so that the fracture and internal fixation extremely unstable, as the adverse impact of fracture healing factor. According to Frangakis report, in Ga rdenlll, Ⅳ fractures, Posterior mild crush, fracture healing rate of 5 per cent, were crushed to moderate 21.3 percent, to severe crush 75%. Posterior comminuted fracture of the former films are often in the x-ray was found on the hard, and in the reduction of the x-ray film, the only clear Show, and the fact that, Posterior, comminuted fracture of the incidence than before judgement is higher.