Femoral neck fractures

1. What are modifiable risk factors for hip fracture?
2. What are complications of a femoral neck fracture? What are complications of surgery for femoral neck fx?
3. What is the presentation for hip fracture?
4. What are the four stages of femoral neck fx?
5. What are the treatments of femoral neck fx?

Answers:
1. Alcohol, caffeine, smoking, antipsychotics, benzos, malnutrition, low body weight.
2. Morbidity from disruption of blood vessels to femoral head, causing necrosis. Postop, can have nonunion or osteonecrosis.
3. Hip pain, limb ext rotation, and apparent shortened limb.
4. Garden stages: I is incomplete, nondisplaced. II is complete, nondisplaced. III is displaced with hip joint capsule partially intact. IV is displaced with hip joint capsule completely disrupted.
5. For stages I and II, pins across fx site, early rehab. For stages III and IV, replacement of femoral head, followed by rehab with hip precautions (no flexion >90, no adduction or internal rotation).