Femoral neck

Clinical features

• Groin pain

• Shortened and externally rotated leg

• Minimal bruising

Diagnostics

• X-ray (AP and lateral view of the pelvis with internal rotation of the affected limb)

• MRI or bone scan if clinical suspicion is high despite absent findings on x-ray

Conservative management

• Indication: stable, nondisplaced fractures, especially abduction fractures , mostly in debilitated patients

• Methods

  • Temporary bed rest or use of crutches followed by mobilization with physical therapy

  • Venous thromboembolism prophylaxis [33]

Surgery (usually within 72 hours ) is indicated for unstable fractures , typically adduction fractures, and fragment dislocation

• For children and young adults

  • Attempt preservation of the femoral head

  • Early open reduction internal fixation (ORIF) (within 6 hours)

• For older adults: total hip replacement (THR) or hip hemiarthroplasty