Title: Femoral neck fractures<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p>
<strong>Femoral neck fracture</strong></p>
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The most commonly missed hip fracture</li>
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We typically think of the presentation of the displaced fracture – severe pain, writhing in the bed, unable to ambulate, limited ROM…</p>
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* However, patients with nondisplaced fractures (15 – 20%) may walk with a limp</p>
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* Occurs primarily in the elderly & osteoporotic population after a fall directly onto the hip</p>
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* Look for a cortical step-off in the femoral neck (w/ foreshortening)</p>
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* A patient with a minimally displaced fracture may only complain of hip, knee, or groin pain and may be able to walk (albeit with a limp)</p>
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* Almost 9% of hip fractures are radiographically normal (Nondisplaced or impacted fractures)</p>
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ú* Fractures which were initially nondisplaced, may become displaced upon re-presentation</p>
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* Remember the limitations of plain x-ray in the evaluation of femoral neck fractures!</p>
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* Because of the significant complication of overlooking a femoral neck fracture, MRI has become the recommended imaging modality of choice for a patient with a high suspicion for a femoral neck fracture, despite normal plain radiographs of the hip </p>