Fracture Neck of Femur

Femoral neck
The It
femur is a long bone comprising:
Epiphysis upper body or diaphysis of the femur Epiphysis lower Colo - well-defin
ed narrowing which is around the head of the femur, is a site of frequent fractu
res
FRACTURE Femoral neck
Occur
often in older people whose bones weakened due to osteoporosis
This type of fracture is three times more frequent in women than in men:
The
woman has a wider bowl, with greater tendency to dislocation of the thigh; In
the post-menopausal women suffer some hormonal changes that are often accompanie
d by an increased incidence of osteoporosis; The life expectancy of women is h
igher to man.
Types of fractures Femoral neck

Intracapsular fractures-subcapitadas-transcervical-Basicervicais extracapsular f

ractures-Intertroncantéricas-Pertroncantéricas-Subtroncantéricas

Clinical Manifestations

Mild pain, lower limb;

Shortening Abduction
or external rotation of the foot;
Functional disability;
Edema; Bruise;
Diagnosis

Physical examination, clinical examination, X-ray examinations.

Treatment
Objectives:

Get a firm grip; Avoid secondary complications; Achieving adequate reduction of

bone; Immobilize the fractured area by the most appropriate technique; Achieving
a functional rehabilitation of the fractured area through the restoration of no
rmal forces.
Treatment:
Conservative Surgery
Intracapsular fractures
Fixation with bone nail the tops of Smith, with or without bone graft; extracaps
ular fractures
Fixing the tops bone plate and nail, using in most cases the technique of Mc Lau
ghlin.
COMPLICATIONS
Thromboembolism
-It is most frequent complications
a
of
Complications
neurocircularórias - may occur due to direct trauma or by increased tissue press
ure. This type of fracture causes bleeding into the interior tissue edema with i
ts excessive.

Hypovolemic shock
Complications
Lung - The deep breathing exercises and changes in position can help in preventi
ng the development of these complications
Ulcers
Pressure - The prevention of pressure sores should be a major concern of nurses.
Must meet the skin care, especially in areas of higher pressure, you must also
meet the placement and use of suitable material helps to reduce the risks electr
olyte dehydration occurs easily leading to electrolyte imbalance, there is also
an increase in confusion
Balance
Incontinence
bladder - should be avoided systematic use of indwelling urinary catheter for lo
ng periods because there is a higher risk of incidence of urinary tract infectio
ns when performing this procedure continuously
Problems
Intestinal
Infection
- Aseptic care pre, intra and postoperative should be strict, because the bone t
issue, the material introduced or the presence of a hematoma, are highly likely
to infect Consolidation - The impairment of vascularization, the posterior commi
nution and osteoporosis are determinants of this complication
Absence
• Avascular necrosis - is common in fractures of the femoral neck. Is related to
the interruption of the vasculature during the trauma or treatment. Revasculari
zation is slow, hence the importance of adequate reduction and fixation of the f
racture • Wear effective disassembly and material for bone
NURSING CARE
Preoperative Preparation
Psychological-Explain procedures to patient-Keep the patient calm Physical Pre
paration-Fasting 8am-Trichotomy-Supine position-evaluate vital signs, check the
process of the patient
NURSING CARE
Postoperative
Pain-related fracture, soft tissue damage, muscle spasm and surgery, mental conf
usion and disorientation related to age, stress trauma, medication, unfamiliar e
nvironment and surgical-wound change patterns of urinary elimination related to
immobility in bed -Decline in physical mobility related to the fracture and to s
tay in bed
Preparation for the High evaluate the domiciliary environment, express concerns,
assess the availability and physical assistance;
Understanding of family and carers; guidelines for health professionals outworke
rs; Advise the patient on post-hospital;
Explain that you should leave the bed of the opposite side for better support;
Advise the patient to the use of materials and care to avoid sharp bending of th
e hip.
END
Presentation made by:
Amelia Antunes Catarina Carvalho Coelho Carla Celeste Davis