Femoral Neck Fractures: Risks and Recovery at 70

Left femoral neck fracture with displacement?

Hello Doctor, I originally collapsed and fell due to sudden fever while undergoing rehabilitation at the hospital.
I was diagnosed with a urinary tract infection and was admitted.
Initially, I thought the fever caused weakness in my left leg, which was a bit painful when moving, but the bruising only appeared the day after the fall.
The pain worsened with movement, and later an X-ray revealed a left femoral neck fracture with displacement, requiring surgery.
However, during my hospital stay, I experienced bloody stools, and an endoscopy showed a duodenal ulcer.
A colonoscopy revealed several adenomas, and I am still waiting for the pathology report.
The orthopedic surgeon said they would only perform surgery after resolving the gastrointestinal and urological issues.
I am very concerned that it has been at least two weeks since my fall and the completion of antibiotics for the urinary tract infection.
I am nearly 70 years old, and I worry that delaying the surgery for my fracture will affect my ability to walk normally in the future.
Will the prognosis worsen?

Mr. Zhang, 60~69 year old female. Ask Date: 2018/01/11

Dr. Hong Ximing reply Orthopedics

Femoral neck fractures require surgical treatment, and if there are other bodily infections, it may increase the surgical risks.
Surgery should only be performed when the patient's condition allows, to avoid impacting the healing and recovery process.

Reply Date: 2018/01/11

More Info

Understanding femoral neck fractures, particularly in older adults, is crucial due to the significant implications for mobility and overall health. At nearly 70 years of age, the risks associated with femoral neck fractures are heightened, especially considering the complications that can arise from delays in surgical intervention.

Femoral neck fractures are common in the elderly, often resulting from falls. In your case, the initial diagnosis of a urinary tract infection (UTI) leading to a fall, followed by the discovery of a displaced femoral neck fracture, is not uncommon. The presence of other health issues, such as the gastrointestinal problems you mentioned (duodenal ulcer and adenomas), complicates the situation further.
The primary concern with femoral neck fractures in older adults is the risk of avascular necrosis (AVN) of the femoral head, which can occur if the blood supply to the bone is compromised. This risk increases with the duration of the fracture before surgical intervention. Delaying surgery can lead to complications such as non-union of the fracture or AVN, both of which can severely impact your ability to walk and maintain independence.

In terms of recovery, the prognosis for a femoral neck fracture largely depends on several factors, including the type of fracture (displaced vs. non-displaced), the timing of the surgery, your overall health, and the presence of comorbid conditions. Studies suggest that the sooner surgical intervention occurs, the better the outcomes in terms of mobility and pain relief. Generally, if surgery is performed within 48 to 72 hours of the injury, the chances of a good recovery are significantly improved.

Given that you have been waiting for two weeks, it is understandable to be concerned about the potential for complications. While it is difficult to predict the exact outcome without a thorough assessment, it is essential to address the fracture as soon as your medical team deems it safe to proceed with surgery. The orthopedic surgeon will likely consider your overall health status, including the resolution of your gastrointestinal issues, before proceeding.

Post-surgery, rehabilitation will be crucial. Physical therapy will help regain strength and mobility in your hip and leg. The goal is to restore function and enable you to walk independently again. The timeline for recovery can vary; many patients begin to bear weight on the affected leg within a few days post-surgery, but full recovery can take several months.

In summary, while the delay in surgery raises concerns, it is essential to focus on resolving your current health issues first. Once cleared for surgery, the orthopedic team will work to minimize the risks associated with the fracture. Engaging in a comprehensive rehabilitation program post-surgery will be vital for your recovery. It is also advisable to maintain open communication with your healthcare providers about your concerns and recovery goals.

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