Fractured Neck of Femur

Fractured Neck of Femur
Pathophysiology and causative factors
A fracture is a break in the continuity of a bone, separating it into two or more parts (Walsh and Crumbie 2007). In the case of a fractured neck of femur following a fall, the fracture is caused by the direct violence applied to the body; hence the fracture occurs at or near the site of the applied force (Walsh and Crumbie 2007). The soft tissues surrounding the area are also involved in the injury (Walsh and Crumbie 2007). Blood vessels within the bone, the periosteum and surrounding tissues are torn, resulting in haemorrhage and then the formation of a haematoma (Walsh and Crumbie 2007). There may also be haemorrhage into adjacent muscles and joints and damage to ligaments, tendons and nerves (Walsh and Crumbie 2007). Soon after a fracture occurs, the muscles in the area go into spasm, causing severe pain and the shortened and rotated appearance of the affected leg in the case of a fractured neck of femur (Walsh and Crumbie 2007).
However, it is unlikely that a young, fit and healthy person would suffer a fractured neck of femur following a fall. Fracture of the neck of femur occurs most often in elderly women, due in part to hormonal changes and the effect this has on bone reabsorption, leading to osteoporosis (Walsh and Crumbie 2007). Osteoporosis is a condition where bone mass is reduced because its deposition does not keep pace with reabsorption (Waugh and Grant 2001). Lowered oestrogen levels after the menopause are associated with a period of accelerated bone loss in women (Waugh and Grant 2001). As bone mass decreases, susceptibility to fractures increases (Waugh and Grant 2001). The weakened bone is less able to resist the force of impact should the person fall (Walsh and Crumbie 2007). Additionally, elderly people are much more likely to fall (Walsh and Crumbie 2007). Cox and Newton (2005) cite data suggesting in excess of 400,000 older people attend accident and emergency departments...