neckfraktur

Neck fracture, in orthopedic terminology, most often refers to a fracture through the neck of the proximal femur, i.e., a femoral neck fracture. It is especially common in older adults after a fall and is strongly linked to osteoporosis, though it can occur in younger patients after high-energy trauma. In other contexts, the term neck fracture can describe fractures of the cervical spine, but in medical literature it typically denotes a femoral neck injury.

Femoral neck fractures are classified as intracapsular (within the hip joint capsule) or extracapsular (for example, intertrochanteric or subtrochanteric). Intracapsular fractures disrupt blood supply to the femoral head, increasing the risk of avascular necrosis and nonunion, especially when displaced. Diagnosis relies on groin or hip pain with limited weight bearing; X-rays are standard, with CT or MRI for occult fractures. The Garden and Pauwels systems are commonly used classifications.

Most patients with neck fractures require surgery, particularly the elderly. Nondisplaced intracapsular fractures may be fixed with cancellous screws; displaced fractures in older adults are often treated with arthroplasty (hemiarthroplasty or total hip) to enable early mobilization, while younger patients may undergo head-preserving fixation. Intertrochanteric fractures are usually treated with intramedullary nails or sliding hip screws. Rehabilitation focuses on early weight bearing as tolerated and prevention of complications; prognosis depends on age, comorbidity, and fracture type.