Femoral neck fracture

Differential Diagnosis

Femur Fracture Types

Proximal

• Intracapsular
  • Femoral head fracture
  • Femoral neck fracture
• Extracapsular
  • Intertrochanteric femur fracture
  • Trochanteric femur fracture

Shaft

• Mid-shaft femur fracture (all subtrochanteric)

Diagnosis

Hip fracture classification.

Location of femur fractures

• Consider AP pelvis in addition to AP/lateral views to compare contralateral side
• Consider MRI if strong clinical suspicion but negative x-ray

References

Femoral Neck

• Common in older pts w/ osteoporosis; rarely seen in younger pts
• Typically minimal bruising (intracapsular)
• If fractured and displaced: externally rotated and shortened
• If non-displaced: pt may be ambulatory
• 30% of pts w/ symptoms suggestive of fx but negative x-rays have fx on MRI
• Management
  • Ortho consult; admit
  • Skeletal traction is contraindicated (may compromise femoral head blood flow)