Proximal femur fracture account for a large proportion of hospitalizations among trauma cases. Over , hip fractures occur each year in the UK, and these injuries are becoming increasingly frequent due to an aging population. At The Orthopaedic & Pain Practice, we want you to understand this serious condition, its management, and what to expect during treatment.

What is a Proximal Femur Fracture?

The proximal femur refers to the upper part of the thigh bone, including the femoral head, neck, and the greater and lesser trochanters. A proximal femur fracture is a break in this upper portion of the femur. These fractures are serious injuries that often require immediate medical attention.

Causes and Risk Factors

In younger individuals, a high-energy traumatic impact, such as a car accident or a fall from a significant height, is usually the cause. However, in the elderly, these fractures typically result from low-energy injuries, such as a fall.

Several factors can increase the risk of a proximal femur fracture:

• Age The majority of patients are over  years old.
• Osteoporosis The loss of bone calcium, reduces bone density, and increases the risk of fractures.
• Gender Women are more likely to experience these fractures than men.

Symptoms of a Proximal Femur Fracture

A fractured proximal femur causes immediate and severe pain. Other common symptoms include:

• Inability to move or stand
• The affected leg may appear shorter and rotated outward
• Bruising, swelling, and stiffness around the hip

Diagnosis

If a proximal femur fracture is suspected, diagnosis typically begins in the emergency department. Doctors can often determine a hip fracture based on the position of the hip and leg, along with the symptoms. Diagnostic procedures include:

• X-rays An X-ray is used to confirm the fracture and determine the affected area.
• CT Scan or MRI These imaging techniques help characterize the fracture type and assess any involvement of cartilage and ligaments.

Treatment Options for Proximal Femur Fracture

Treatment for a proximal femur fracture typically involves a combination of surgery, medication, and rehabilitation.

Non-Surgical Treatment

• Pain Management Pain medications, including over-the-counter NSAIDs or prescription opioids, provide short-term relief.
• Fluid Replacement This is done prior to radiologic evaluation.

Surgical Treatment

Surgery is often necessary, and should ideally occur within one to two days of the injury. The specific surgical procedure depends on the type of fracture and the patient’s overall health.

• Internal Fixation For non-displaced fractures, internal fixation using screws, nails, plates, or rods may be used to stabilize the bone fragments.
• Arthroplasty In the geriatric age group, early prosthetic replacement brings down the mortality and morbidity associated with neck femur fractures.
• Intramedullary Nailing The operative management of intertrochanteric and subtrochanteric fractures favors intramedullary nailing.

Post-Operative Care

After surgery, focus shifts to preventing complications and restoring function.

• Rehabilitation Early mobilization and geriatric care are essential for recovery.
• Medications Prophylactic anti-clotting medications may be administered to prevent deep vein thrombosis.

Potential Complications

Complications can arise following a proximal femur fracture, including:

• Local infection
• Deep vein thrombosis (DVT) and pulmonary embolism
• Blood loss
• Fracture nonunion

Final Thoughts

Dealing with a proximal femur fracture can be overwhelming, but with prompt diagnosis and appropriate treatment, patients can achieve good outcomes. At The Orthopaedic & Pain Practice, we are committed to providing comprehensive care for patients with proximal femur fractures. Our team works closely with each patient to develop a personalized treatment plan, manage pain, and restore function.