Anatomy of Femoral Neck and fracture

Femoral neck is that region which connects the shaft of a femur (thigh bone) to its round head to fit into a hip joint. A femoral neck can be potentially weak due to the relatively small area of cross-section and the cancellous bone which is just a sponge like bone tissue. Since, it is on the critical axis for weight-bearing in the body, it is susceptible to most injuries related to the thigh bone. Also, it is common place for cysts, osteoporosis and birth defects.

Femoral Neck Osteoporosis: Osteoporosis is the gradual decrease of calcium content in the bones thereby making them weak and brittle. Due to chemical imbalance effected by cessation of key hormones and sedentary lifestyle, elderly ladies often have this form of osteoporosis after menopause. This can result in pain in the bones and increased chances of fracture. Leading an active lifestyle can delay or prevent the occurrence of this problem.

Femoral Neck Cysts: Fluid filled cavities in the bone are called bone cysts. They reduce bone strength making chances of its fracture higher. Although these may be present from childhood, they are usually detected following a fracture or other investigation. They usually do not need treatment unless they are large or getting larger with the possibility of turning into a bone tumour.

Femoral Neck Deformity

A femoral neck is at a 120-135 degree angle to the shaft of a thigh bone. It functions like a lever to ease the muscle action in the area of the hip joint. A change in this femoral neck angle beyond the reasonable limits can cause improper muscle action  and interfere with the ability to walk. Increase in this angle can cause outward curvature and decrease in this angle can cause inward curvature of a hip joint thereby resulting in early arthritis of the hip joint arthritis. This can also lead to hip dislocations. Femoral neck osteotomy is the surgery which can fix this problem by cutting and realigning to restore the angle within its normal range.

Femoral Neck Fractures

These can be caused by road accidents in adults. In children, this can lead to deformation of the femoral neck. Elderly often suffer from these fractures due to osteoporosis. A femoral neck fracture results in the femoral head losing blood supply to become avascular. Further, this can result in the death of head tissue of the femur within 6 hours.

Treatment of femoral neck fracture is a factor of how much time has elapsed since the injury coupled with the patient’s age.

If the injury has occurred less than six hours ago, then a fix with three metallic screws to restore blood supply to the femoral head can be effective. This surgery works well for the young but the elderly with osteoporosis will not be recommended this surgery.

If the injury has occurred more than six hours ago, partial replacement of the hip is the only solution. This surgery can be quite expensive and certain restrictions will always apply.

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