Non-surgical treatment:
1. Femoral fractures: for patients with no dislocation, no significant shift or compression fracture, bed rest for three weeks, ambulation activities. Bedridden articular cartilage may lead to ischemic necrosis and stiffness.
2. Femoral neck fracture:
(1) For patients with no displacement, no abduction or intercalation fractures who can not accept sugery, non-surgical method of treatment is better.
(2) Wear orthopedic shoes or skin traction 8-12 weeks, canes 3 months, 6 months to walk.
Intertrochanteric fracture: Medical complications after internal fixation of less than non-surgical treatment and light. So the non-surgical treatment of intertrochanteric fracture of has been abandoned.
3.Subtrochanteric fractures: non-surgical treatment such as tow, of which efficacy varies.
Surgery
1. femoral fractures:
(1) Patients associated with fracture dislocation should be immediately reset. If reset has been failed twice, surgery should be considered.
(2) When fragment obvious collapse or displacement occurs, or embed joint space with surgical reduction of dislocation failed or nerve has been injured, requiring immediate surgery.
(3) Small chip fracture, which may be removed.
(4) Collapse of the fracture, which shall pry and autologous cancellous bone liner.
If the range of fracture surface subsidence is more than half of the weight-bearing joints or comminuted fracture fixation is difficult to perform or ipsilateral femoral neck fracture, joint replacement surgery should be considered;
(5) Larger fracture when thick, fixed by cancellous lag screws or absorbable screws.
2. femoral neck fracture:
(1) non-cuting joint capsule: fixed by screws, plates, etc.
(2) Cuting joint capsule: arthroplasty.
3. Intertrochanteric fracture:
Intertrochanteric fracture fixation devices commonly have two categories: sliding compression hip screw with steel side and intramedullary device.
4. subtrochanteric fractures
(1) hip compression screw and side plate fixation are common method for subtrochanteric fractures fixation.
(2) If the medial cortical support can not be restored, you should use nail;
(3) indirect reduction, 95 ° condylar plate fixation;
(4) Patients with pathologic fracture disease under the rotor are best to use nail reconstruction which can ensure the stability of the entire femur.
(5) Femoral shaft fractures with ipsilateral femoral neck fracture: reconstruction nail fixation.
(6) Proximal femoral fractures which can not be repaired: hip replacement.