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Proximal Femur Fractures
Hip fractures are common (250,000/year in the United States), particularly among elderly women (74% >65 years old; female:male, 4:1). They occur commonly after falls, and it is important to elicit any antecedent symptoms such as chest pain or dizziness that may indicate a primary medical or surgical condition that caused the fall.
Causes
- Proximal Femur Fractures may be caused by trauma such as motor vehicle trauma, Sports, Falls, Gunshot wounds, Metabolic bone disease, Tumors.
- It may also occur due to Lytic lesions including cancerous metastasis, paget disease, bone cysts.
- Several factors that may cause stress fracture including running, jogging, amenorrheic or oligomenorrheic female runners, abnormal bone mineral density, improper training, improper footwear.
Signs
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Thigh, knee, or groin pain
- Affected extremity may appear shortened and externally rotated if displaced; however, alignment may be normal, and the patient may even be ambulatory if there is no displacement.
Treatment
- Treatment for acute trauma-related femoral fractures is performed by an orthopaedic surgeon and usually involves surgical stabilization.
- For stress fractures of the medial compression side, protected crutch-assisted touch-down weight bearing is implemented for 1-4 weeks, based on the resolution of symptoms. Progression to full weight bearing can gradually commence once pain has resolved. You should also avoid running for 8-16 weeks while the low-impact training program/phase is completed. In which, the progression can including cycling, swimming, running in chest-deep water prior to resuming more intensive weight-bearing training. Patients must maintain upper extremity and cardiovascular fitness and avoid lower extremity exercise early in the healing process.
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