The term "hip fracture" refers to a fracture of the proximal femur, be it in the femoral neck, across the trochanters, or below the trochanters.
Femoral neck fractures (especially if displaced) may compromise the blood supply to the femoral head and increase the risk for avascular necrosis and nonunion. Earlier operation is preferred for optimal technical results if the femoral head is to be preserved.
Intertrochanteric and subtrochanteric fractures occur in well-vascularized areas and pose less risk of osteonecrosis.
There are several options for surgical repair:
Internal fixation with multiple screws can be used for minimally displaced femoral neck fractures; a sliding hip screw may be used for intertrochanteric fractures.
Prosthetic replacement of the femoral head is done if significant displacement occurs. However, compared with internal fixation, this procedure carries a higher operative risk from blood loss and anesthesia time..
Tomorrow we will discuss why operate immediately?
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