Postoperative care and rehabilitation care for femoral neck fracture should be done well

Femoral neck fracture is most common among elderly people with osteoporosis. Generally, the elderly are weak. Once a femoral neck fracture occurs, it will easily cause many complications. Timely surgical treatment is required. Postoperative care is more important, and family members must provide comprehensive care.

1. Posture

After the operation, the affected limb must be kept in abducted neutral position, and a soft pillow should be placed under the operated limb to keep the hip joint slightly flexed. You can place a soft pillow or triangular pad between your legs and wear anti-external rotation shoes. When moving or transporting a patient, the entire hip joint should be lifted, and not just the affected limb. The bedside table should be placed on the surgical side to prevent the patient from rolling to the opposite side and placing the surgical hip joint in an externally rotated and extended position. When lying on the healthy side, the two legs must be separated by a large soft pillow to prevent the hip joint from flexing more than 45°~60°. If you find that the affected limb is shortened, you should contact your doctor immediately and take X-rays to check whether it is dislocated. 

2. After surgery, start early functional training under pain-free conditions , following the principles of gradual progression, passive plus active, isometric and isotonic exercises [2]. On the day after surgery, centripetal massage of the affected limb starting from the dorsum of the foot, active and passive flexion and extension exercises of the toes and ankle joints can be performed. On the second day after surgery, isometric contraction exercises of the hamstrings, quadriceps, gluteus maximus and gluteus medius can be performed to maintain muscle tension. The drainage tube was removed 2-3 days after surgery. Go for anti-external rotation shoes. You can then perform hip and knee flexion and extension exercises, hip extension and rotation exercises to train the hip joint range of motion. The flexion and extension exercises gradually transition from passive to active with assisted, and then to fully active exercises. Passive training is often assisted by a CPM device. The range of motion can be adjusted at any time and gradually increased. The movement speed is relatively slow and even, which is easily accepted by patients. Generally, the maximum motion angle at the beginning of CPM is set at 40°. At this time, the range of motion of the hip joint is 25°~45°, and then it will increase by 5°~10° every day. Each movement is maintained in a contracted state for 5s, and then relaxed for 5s, 20~30 times/group, lasting for 1h, 2 times/d, until about 1 week after surgery. Hip rotation exercises include extension and flexion positions. When practicing the hip flexion position, hold the bed support with both hands and swing the upper body slightly left and right. Be careful not to let the buttocks leave the bed. When the hip flexion position on the surgical side is unstable, avoid tilting the upper body toward the surgical side. In addition, upper limb muscle strength exercises should be strengthened so that crutches can be used better in the future.