Neck of femur fracture medical therapy: Difference between revisions
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==Medical Therapy== | ==Medical Therapy== | ||
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[[File:Derotational boot.JPG|400px|thumb|Conservative management with derotational cast [https://upload.wikimedia.org/wikipedia/commons/2/22/Bullous_pemphgoid_in_a_72_year_old_bedridden_female3.JPG Source: Case courtesy of Ashashyou [CC BY-SA 4.0 (https://creativecommons.org/licenses/by-sa/4.0)], from Wikimedia Commons]]] | |||
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The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.<ref name="pmid19058696">{{cite journal| author=Faraj AA| title=Non-operative treatment of elderly patients with femoral neck fracture. | journal=Acta Orthop Belg | year= 2008 | volume= 74 | issue= 5 | pages= 627-9 | pmid=19058696 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19058696 }} </ref><ref name="pmid26263935">{{cite journal| author=Moulton LS, Green NL, Sudahar T, Makwana NK, Whittaker JP| title=Outcome after conservatively managed intracapsular fractures of the femoral neck. | journal=Ann R Coll Surg Engl | year= 2015 | volume= 97 | issue= 4 | pages= 279-82 | pmid=26263935 | doi=10.1308/003588415X14181254788809 | pmc=4473865 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26263935 }} </ref><ref name="pmid18646065">{{cite journal| author=Handoll HH, Parker MJ| title=Conservative versus operative treatment for hip fractures in adults. | journal=Cochrane Database Syst Rev | year= 2008 | volume= | issue= 3 | pages= CD000337 | pmid=18646065 | doi=10.1002/14651858.CD000337.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18646065 }} </ref><ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref> | The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.<ref name="pmid19058696">{{cite journal| author=Faraj AA| title=Non-operative treatment of elderly patients with femoral neck fracture. | journal=Acta Orthop Belg | year= 2008 | volume= 74 | issue= 5 | pages= 627-9 | pmid=19058696 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19058696 }} </ref><ref name="pmid26263935">{{cite journal| author=Moulton LS, Green NL, Sudahar T, Makwana NK, Whittaker JP| title=Outcome after conservatively managed intracapsular fractures of the femoral neck. | journal=Ann R Coll Surg Engl | year= 2015 | volume= 97 | issue= 4 | pages= 279-82 | pmid=26263935 | doi=10.1308/003588415X14181254788809 | pmc=4473865 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26263935 }} </ref><ref name="pmid18646065">{{cite journal| author=Handoll HH, Parker MJ| title=Conservative versus operative treatment for hip fractures in adults. | journal=Cochrane Database Syst Rev | year= 2008 | volume= | issue= 3 | pages= CD000337 | pmid=18646065 | doi=10.1002/14651858.CD000337.pub2 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18646065 }} </ref><ref>{{cite book | last = Rockwood | first = Charles | title = Rockwood and Green's fractures in adults | publisher = Wolters Kluwer Health/Lippincott Williams & Wilkins | location = Philadelphia, PA | year = 2010 | isbn = 9781605476773 }}</ref><ref>{{cite book | last = Azar | first = Frederick | title = Campbell's operative orthopaedics | publisher = Elsevier | location = Philadelphia, PA | year = 2017 | isbn = 9780323374620 }}</ref> | ||
Revision as of 17:27, 7 February 2019
Neck of femur fracture Microchapters |
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Neck of femur fracture medical therapy On the Web |
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Risk calculators and risk factors for Neck of femur fracture medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]
Overview
The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.
Medical Therapy
The mainstay of treatment for neck of femur fracture is surgery. Non-operative management is reserved for a very small proportion of patients.[1][2][3][4][5]
Non-operative Treatment
Indications
- Non-ambulators
- Patients with minimal pain
- Patients who are at high risk for surgical intervention
Techniques
- Derotational cast
- Traction
Complications
- Osteonecrosis
- Non union
- Complications Of Prolonged Recumbency such as:
- Hypostatic pneumonia
- Pressure sores
- Deep venous thrombosis
- Pulmonary embolism
- Cardiac failure due to weakening of the cardiac muscle and poor venous return
- Muscle wasting
- Common peroneal nerve palsy
- Stiffening of joints
- Osteoporosis
- Urinary tract infections
- Depression
References
- ↑ Faraj AA (2008). "Non-operative treatment of elderly patients with femoral neck fracture". Acta Orthop Belg. 74 (5): 627–9. PMID 19058696.
- ↑ Moulton LS, Green NL, Sudahar T, Makwana NK, Whittaker JP (2015). "Outcome after conservatively managed intracapsular fractures of the femoral neck". Ann R Coll Surg Engl. 97 (4): 279–82. doi:10.1308/003588415X14181254788809. PMC 4473865. PMID 26263935.
- ↑ Handoll HH, Parker MJ (2008). "Conservative versus operative treatment for hip fractures in adults". Cochrane Database Syst Rev (3): CD000337. doi:10.1002/14651858.CD000337.pub2. PMID 18646065.
- ↑ Rockwood, Charles (2010). Rockwood and Green's fractures in adults. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 9781605476773.
- ↑ Azar, Frederick (2017). Campbell's operative orthopaedics. Philadelphia, PA: Elsevier. ISBN 9780323374620.