Conservative treatment of femoral neck fracture, common treatment methods

Femoral neck fractures may occur at any age, especially in middle-aged and elderly people, and most of the patients are female. The principle of conservative treatment of femoral neck fractures is to avoid surgery as much as possible and to perform more appropriate activities and exercises in the early stage.

1. Conservative treatment

First, avoid surgery as much as possible to minimize the damage to the injured area.

Second, early activities and early functional exercises can promote blood circulation and reduce joint stiffness.

Third, by using drugs to dilate the remaining capillaries and repair damaged capillaries, blood supply is promoted to ensure that the active ingredients of the drugs reach the lesion site.

Through comprehensive treatment in three aspects, the therapeutic effect is significant. Moreover, from long-term clinical observation, the earlier the femoral neck fracture is treated according to the Chenglin therapy, the better the effect.

2. Treatment points

(1) Non-surgical treatment: For fresh, non-displaced, stable abduction fractures, use skin traction or wear T-strap shoes.

(2) Open reduction and internal fixation.

(3) Drug treatment: Take bone-setting soup orally once a day, one bottle (50 ml) at a time, for 48-72 bottles in a row, or use Didao Shenggu granules, once in the morning and evening, one packet (10 g) at a time, for 160-240 packets in a row; if it is the subcervical type, take bone-setting soup orally once a day, one bottle (50 ml) at a time, for 72-96 bottles in a row, or use Didao Shenggu granules, once in the morning and evening, one packet (10 g) at a time, for 240-320 packets in a row.

(4) After taking the oral medication, do dorsiflexion exercises 3,000 to 5,000 times a day, and exercise walking with the help of a bed, with crutches, or without crutches, for 10 minutes to 2 hours a day, depending on the condition of the patient.

3. General treatment methods

1. External fixation: Suitable for abduction and intermediate fractures. Generally, traction of the affected limb or anti-external rotation shoes are used for 8 to 12 weeks to prevent the affected limb from external rotation and adduction. It takes about 3 to 4 months to heal, and non-union or femoral head necrosis rarely occurs. However, fractures may be dislocated in the early stages, so some people advocate the use of internal fixation. As for plaster external fixation, it is rarely used and is limited to younger children. Internal fixation has the widest indications. It is applicable to most adduction fractures. It usually takes about 4 to 6 months to heal. After the fracture heals, observation should continue until five years after the operation to facilitate early detection of femoral head avascular necrosis.

2. Internal fixation: Currently, hospitals with the necessary conditions use closed reduction and internal fixation with the cooperation of TV X-ray machines. If there is no X-ray equipment, open reduction and internal fixation can also be used. Manual reduction should be performed before internal fixation, and internal fixation should be performed only after the anatomical reduction of the fracture ends is confirmed.

3. Internal fixation and bone grafting: For fractures that are difficult to heal or old fractures, bone grafting is performed simultaneously with internal fixation to promote healing. There are two bone grafting methods:

① Free bone grafting: such as taking strips of fibula or tibia and inserting them into the femoral head from under the greater trochanter, or filling bone defects with cancellous bone.

② Pedicled bone grafting: The most commonly used method is sartorius muscle pedicled bone flap grafting. With the advancement of microsurgical technology, vascularized bone grafting has been developed. Such as bone transplantation of the deep circumflex iliac artery bone flap.