Proximal femur fractures account for over 40% of hip fractures, making them a significant challenge in orthopedic care. This statistic underscores the importance of understanding this common yet complex injury. Whether you’re a healthcare professional, a caregiver, or someone recovering from such an injury, knowing the ins and outs of proximal femur fractures is critical for effective management and recovery.

What Is a Proximal Femur Fracture?

A proximal femur fracture refers to a break in the upper part of the femur (thigh bone), near the hip joint. This region includes the femoral neck and the intertrochanteric area. These fractures are often categorized into two main types:

• Femoral Neck Fractures: These occur just below the femoral head, within the capsule that lubricates the hip joint. They are intracapsular fractures and can disrupt blood flow to the femoral head, leading to complications like avascular necrosis.
• Intertrochanteric Fractures: These occur between the greater and lesser trochanters (bony protrusions on the femur) and are extracapsular fractures. They generally have better blood supply and lower risk of complications compared to femoral neck fractures.

Causes and Risk Factors

Most proximal femur fractures result from trauma, such as falls or car accidents. However, certain factors increase susceptibility:

• Age: Individuals over  are at higher risk, particularly postmenopausal women due to reduced bone density.
• Medical Conditions: Osteoporosis, bone cancer, or other conditions weakening bone structure significantly raise fracture risk.
• Lifestyle Factors: Poor nutrition, lack of exercise, or smoking can contribute to bone fragility.

Symptoms of a Proximal Femur Fracture

Recognizing a proximal femur fracture is crucial for timely treatment. Common symptoms include:

• Severe pain in the hip or groin area.
• Inability to bear weight on the affected leg.
• The injured leg appearing shorter or externally rotated.
• Swelling and bruising around the hip.

If you suspect a fracture, seek immediate medical attention.

Diagnosis

A thorough physical examination combined with imaging studies is essential for diagnosing proximal femur fractures. Doctors typically use:

• X-rays: To confirm the location and type of fracture.
• CT Scans: For more detailed imaging in complex cases.

Treatment Options

Treatment for proximal femur fractures depends on factors like fracture type, patient age, and overall health. Options include:

Surgical Intervention

Surgery is often necessary to restore mobility and prevent complications. Common procedures include:

• Internal Fixation: Screws or plates stabilize nondisplaced fractures.
• Hemiarthroplasty or Total Hip Arthroplasty: Replacement of the femoral head for displaced femoral neck fractures.
• Intramedullary Nailing: A rod inserted into the femur’s shaft for intertrochanteric fractures.

Pain Management

Pain relief is critical during recovery. Options range from over-the-counter NSAIDs to prescription opioids for severe cases.

Rehabilitation

Physical therapy plays a pivotal role in regaining strength and mobility post-surgery. Early mobilization reduces risks of complications like blood clots and muscle atrophy.

Complications to Watch For

Proximal femur fractures can lead to serious complications if not managed properly:

• Avascular Necrosis: Loss of blood supply to the femoral head.
• Malunion or Nonunion: Improper healing of the fracture.
• Infections or Blood Clots: Post-surgical risks that require close monitoring.

Prevention Strategies

Preventing proximal femur fractures involves addressing modifiable risk factors:

• Maintain strong bones through a diet rich in calcium and vitamin D.
• Engage in regular weight-bearing exercises like walking or resistance training.
• Minimize fall risks by ensuring safe home environments (e.g., removing tripping hazards).

Proximal femur fractures are life-altering injuries but with proper treatment and rehabilitation, recovery is achievable. For more detailed information about managing this condition, visit The Orthopaedic and Pain Practice.