Collum femoris fracture

definition: fracture in the thy neck

Causes:
falling on the trochanterregion (op the zijkant of the hip). sometimes by axiaal directly forces (through falling on gestrekt been).
classification: 1 not dislocated, geïnclaveerde (op X-hip AP over 160degrees Celcius dislocation of the medial trabeculae tov the medial femur cortex. Geen beenverkorting) fracture. 2 dislocated, instable fracture
classification: follows Powels: helling of the fracturelijn becomes bepaald. Powels I (tot 30 degrees Celcius), Powels II (tot 50 degrees Celcius), Powels III (bigger then 50 degrees Celcius)

Frequency:

Risk factors:
aging, female zijn

Symptoms:
Been verkort
Been ligt to outside twisted (exorotation)
Staan on leg is onpossible of zeer painlijk
pain bij movement hip

Complications:
-immobilisation related problems
-Uitbreken prothesis
-Pseudo-arthrosis (not healing fracture)
-femur headnecrosis (hip headafsterving)
-chronic pain
-Iatrogene kniecomplaints after tractie (pain in the knee after the trekken aan the leg om the fracture weer recht te zetten)
-Incomplete can use of the hip

Diagnostics:
X-pelvis anterior-posterior and axiale hipopname

Treatment:
-Repositie door tractie and endorotation. if the not lukt then de handgreep of Leadbetter. if also that not lukt then bij patients younger then 70 open repositie.
After repositie DHS (dynamic hip screw) sites of gecanuleerde schroeven
-if older then 60 and no repositie possible is, of bij Parkinson, severe osteoporosis, comminutieve fracture, pathologic fracture een head/neckprothesis. head/neckprothesis is directly belastbaar.
-if younger then 60 and no repositie possible total hipprothesis

Checkup:
under doorlichting after 2 (stitches removal by general practitioner), 6, 12 weeks, 6 and 12 months controle.

Additional information:
healing after 12 weeks
 

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