The patient and caregivers may be encouraged to use additional support when rising from a sitting position.ĭislocation precautions can gradually be relaxed after 6 weeks, once the soft tissues have healed. Low seats and toilets, flexing the hip when arising, sitting with legs crossed, as well as squatting and kneeling may also be avoided initially, as should pivoting on the affected leg. Position to avoid after the anterior approach: Combined adduction past midline, external rotation, and hyperextension.Position to avoid after the posterior approach: Combined adduction across the midline, internal rotation, and hip flexion of more than 80°–90°. ![]() The surgeon may apply the following restrictions as necessary. To reduce the risk of prosthetic hip dislocation during the first 6 postoperative weeks, patients may require certain leg positions and activity restrictions. Properly positioned prostheses and appropriate soft-tissue tension (when closing) reduce the dislocation risk. Closed basicervical fracture of neck of right femur Right femur base of neck (upper leg bone) fracture ICD-10-CM S72.041A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. Prosthetic dislocations, occurring 2–6% or more in recent reports, are serious complications that compromise medical and functional outcomes. Total hip arthroplasties performed for femoral neck fractures should only be performed by surgeons that are competent in doing the procedure.įor a comparison between total hip arthroplasty and hemiarthroplasty, see, eg, Ekhtiari et al 2020, Tang et al 2020. In patients with preexisting osteoarthritis, total hip arthroplasty is also indicated. Reported results of total hip arthroplasty for femoral neck fractures are improving, so that total hip arthroplasty is increasingly favored for displaced femoral neck fractures, particularly for more active elderly patients. Hemiarthroplasty is cheaper and has a lower risk of dislocation than total hip arthroplasty but may lead to acetabular pain and erosion, requiring revision surgery at a later date. ![]() Hemiarthroplasty is a less complicated operation and provides generally satisfactory results for less active elderly patients. The two major types are hemiarthroplasty (replacement of the femoral head and neck) or total hip arthroplasty, in which both the femoral head and neck and the acetabular surface are replaced. If arthroplasty is chosen, the next issue is what kind of arthroplasty. The first is whether to fix the fracture or to perform an arthroplasty. The surgeon is faced with several choices for arthroplasty for a femoral neck fracture.
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