FEMORAL NECK FRACTURE
The femoral neck is the section of the thigh bone (femur) closest to the hip. A femoral neck fracture, also called a neck of femur fracture, is accordingly a break in this area of bone near the hip joint. In practice, people often simply speak of a hip fracture.
This injury is life-changing and can abruptly alter everyday life for those affected. That is exactly why a good understanding of the causes, treatment and rehabilitation is so important.
DIFFERENCES BETWEEN AGE GROUPS AND ACTIVITIES
Femoral neck fractures occur very differently depending on the stage of life.
In older people, the fracture often happens after a seemingly harmless fall. The reason is usually osteoporosis, the gradual loss of bone substance. This makes bones porous and much more brittle. Even everyday situations such as slipping at home can then lead to a fracture. Factors such as unsteady walking, dizziness or vision problems increase the risk of falling even further.
In younger people, this injury is much rarer and usually occurs only with high-impact force, typically in sport or in road accidents.
CAUSES IN OLDER PEOPLE
In older age, bone structure plays a central role. Osteoporosis makes bone lose stability, so that even minor loads can lead to fractures. This so-called "fragility fracture" is often not only physically demanding but also a life-changing event in everyday life.
TYPICAL CAUSES IN SPORT
In younger people, a femoral neck fracture usually results from a severe trauma with high energy, for example:
- Road accidents
- Falls during sport
- Sports accidents at high speed or with high force
Particularly high-risk sports are:
- Contact sports such as football or American football
- Skiing
- Extreme sports such as base jumping, skydiving or unprotected climbing
SYMPTOMS OF A FEMORAL NECK FRACTURE
A classic sign is a leg that looks shortened and is rotated outwards. There is also severe pain in the hip area, often with an inability to lift the leg actively or put weight on it.
With displaced fractures, there is also a risk that the blood supply to the femoral head is disrupted. In the worst case, the bone tissue can die, a condition that requires surgery quickly.
With impacted fractures, the symptoms are often less clear. Some people feel only a dull pain, which can even radiate towards the knee. This is why the diagnosis is usually confirmed with an X-ray.
TREATMENT OF A FEMORAL NECK FRACTURE
Treatment depends heavily on stability and the type of fracture.
Conservative therapy
In rare cases, stable fractures with hardly any displacement can be treated conservatively. The hip is protected and initially only partially weight-bearing. Careful mobilisation is carried out with physiotherapy support.
Surgical treatment (the standard case)
In most cases, however, surgery is necessary, especially in older people, because getting moving quickly is decisive for the outcome.
A distinction is made between:
1. Head-preserving surgery
The fracture is stabilised with screws or plates.
Aftercare: partial weight-bearing on forearm crutches for about 6–7 weeks.
2. Head-replacing surgery (hip replacement)
The femoral head is replaced and stabilised with a prosthesis.
Here, earlier weight-bearing is often possible.
HEALING TIME
- Head-preserving surgery: partial weight-bearing for about 6–8 weeks, return to sport after about 6 months
- Hip replacement: usually earlier full weight-bearing is possible, but functional rebuilding over weeks is still necessary
OUTLOOK AND LATE COMPLICATIONS
A femoral neck fracture is a serious injury, especially in older age. Despite modern medicine, complications can occur.
Possible late complications:
- Wound healing problems or infections
- Deep vein thrombosis in the legs
- Loosening or dislocation of the prosthesis
- Periprosthetic fractures in the event of further falls
Today, however, a hip replacement can often work reliably for many years (up to about 15 years).
WHAT DOES REHABILITATION LOOK LIKE?
Acute phase
After surgery or conservative treatment, the first priority is offloading. Depending on the procedure, you may only put partial weight on the hip. In this phase, physiotherapy and mobilisation with crutches are decisive.
Early rehabilitation phase
The focus is on:
- Gait training with forearm crutches
- Reducing swelling (e.g. lymphatic drainage)
- First mobilisation exercises
- Preventing muscle loss
Build-up phase
Once healing progresses, active rebuilding begins:
- Strength training
- Coordination
- Balance
- Functional training
Return to everyday life
After about 6 months, depending on how things go, a return to more demanding activities and, in some cases, sport is possible.
WHAT YOU CAN DO YOURSELF
A femoral neck fracture is not something you can simply "sit out". But you can actively contribute a lot to your healing.
Straight after the injury / surgery
- Consistent offloading
- Using walking aids
- Regular physiotherapy
Thrombosis prevention (important!)
A simple but very effective exercise:
- Lie on your back
- Knees straight
- Point and flex your feet once a second
- Several times a day, 3 × 20 repetitions
In the long term
- Building up the leg muscles
- Stabilising the trunk
- Coordination training
- Slowly building up load
PREVENTION
Prevention is especially important, particularly in older age:
- Regular exercise
- Stability and strength training
- Improving balance and coordination
- Fall prevention in everyday life (e.g. barrier-free living)
- Promoting circulatory stability
Exercise is not just training here. It protects your bones, joints and independence.
HOW KINEO CAN HELP YOU
A femoral neck fracture is a life-changing experience. Many people feel unsure in this phase, sometimes even overwhelmed. This is exactly where targeted physiotherapy comes in.
At KINEO, we guide you step by step through rehabilitation, adapted to your load tolerance and your goal.
Straight after surgery
- Lymphatic drainage to reduce swelling
- Manual therapy for mobilisation
- Gait training with crutches
- First activation exercises against muscle loss
Build-up phase
- Individually adapted strength training
- Stabilising the trunk and leg axis
- Functional training to cope with everyday life
- Coordination training
Late rehab
- Building strength and endurance
- Improving load tolerance
- Preparing for everyday life and, if applicable, sport
Optional:
- Medical training therapy (MTT) in Thalwil, Wipkingen or Escher Wyss
- Training on the SensoPro
- Functional machine training
The aim is not just healing, but a safe, stable and self-determined return to movement.
FAQ: FEMORAL NECK FRACTURE
1. How long does healing take after a femoral neck fracture?
Healing depends on how the fracture was treated. After head-preserving surgery, rehabilitation usually takes several months, with full load tolerance after about 6 months. With a hip replacement, weight-bearing is often possible earlier, but functional rebuilding is still important.
2. Can I put weight on the leg straight after surgery?
No. Weight-bearing depends on the surgical procedure. Usually only partial weight-bearing is allowed at first, and it is increased step by step.
3. What are the risks?
Possible complications are thrombosis, infections, wound healing problems or problems with the prosthesis. Early mobilisation significantly reduces many of these risks.
4. Can I do sport again?
Yes, but step by step. Low-impact sports such as cycling or swimming are often possible earlier. High-impact sports only after full rehab and clearance.
5. What can I actively do myself?
Consistent physiotherapy, regular exercise within the permitted limits, building muscle and sticking to the weight-bearing instructions are decisive for a good recovery.
