Femoral neck fractures occur more often in the elderly, with a higher incidence in women than in men. Older adults have varying degrees of osteoporosis, and women in particular are more prone to fractures due to the early onset of osteoporosis for physiological reasons (menopause). For elderly people with femoral neck fracture, artificial hip arthroplasty is a successful operation that can immediately relieve and eliminate joint pain, increase limb mobility and improve patients’ quality of life.
I. Pre-operative preparation.
The surgeon will conduct a comprehensive examination of the patient before surgery, including: physical examination, laboratory tests, dental examination, urinary tract examination, etc. These necessary tests will be helpful in assessing the patient’s physical condition and formulating a surgical plan to reduce the chance of infection after surgery.
II. Surgical situation
The operation takes about 1-1.5 hours. The surgeon removes the femoral head and the diseased bone and cartilage, installs an artificial prosthesis, and restores the patient’s hip function.
Post-operative rehabilitation
1.Functional exercise
(1) Hip extension.
(1) Tighten the gluteal muscles and slightly lift the hip, and keep it for five minutes.
(2) Straighten the knee and extend the lower limb with the joint backward.
(2) Hip flexion.
(1) lying down, agitate the heel toward the hip, paying attention to hip flexion no greater than 90 degrees.
② Standing, pay attention to the hip flexion is not greater than 90 degrees.
(3) Knee extension.
Lift one leg about 15 cm, hold it for 5 seconds, then change one leg and repeat 10 times.
(4) Hip abduction.
(1) Keep the toes up in bed, straighten the lower limb and spread the lower limb outward.
②Stand with the lower limb straight, spread the lower limb outward, hold for 5 seconds, repeat 10 times.
2.The correct posture of getting out of bed
(1) Move the affected limb closer to the edge of the bed
(2) Lower the lower leg slowly
(3) Try not to put weight on the affected side
(4) Hold the walker with the hand on the healthy side, hold the edge of the bed with the hand on the affected side and stand slowly.
3.The correct posture of using crutches
(1) stand first out of the left crutch
(2) Step on the right foot
(3) Out of the right crutch
(4) Step on the left foot
Preventing complications
1.Prevention of dislocation
(1) Do not cross the affected limb to the opposite side when standing
(2) Do not excessively externally rotate the affected limb
(3) Do not bend more than 90 degrees when bending over
(4) Do not bend the body more than 90 degrees when sitting up
(5) Do not cross your legs
2.Prevention of venous thrombosis.
Starting functional exercise as early as possible is the fundamental measure to prevent venous thrombosis.
3.Prevention of pulmonary infection.
Ask the patient to sit up and encourage coughing to prevent crushing pneumonia.
V. Postoperative follow-up
After the operation, patients should come to the hospital once a year for routine follow-up examinations and X-rays at 1 month, 3 months, 6 months, 12 months and then once a year. The purpose of the follow-up visit is to guide the patient for further rehabilitation training in order to achieve the best results of the operation.