Fracture Neck of Femur Femoral neck The It femur is a long bone comprising: Epiphysis upper body or diaphysis of the

femur Epiphysis lower Colo - well-defin ed narrowing which is around the head of the femur, is a site of frequent fractu res FRACTURE Femoral neck Occur often in older people whose bones weakened due to osteoporosis This type of fracture is three times more frequent in women than in men: The woman has a wider bowl, with greater tendency to dislocation of the thigh; In the post-menopausal women suffer some hormonal changes that are often accompanie d by an increased incidence of osteoporosis; The life expectancy of women is h igher to man. Types of fractures Femoral neck Intracapsular fractures-subcapitadas-transcervical-Basicervicais extracapsular f ractures-Intertroncantéricas-Pertroncantéricas-Subtroncantéricas

Clinical Manifestations Mild pain, lower limb; Shortening Abduction

or external rotation of the foot; Functional disability; Edema; Diagnosis Physical examination, clinical examination, X-ray examinations. Bruise;

Treatment Objectives: Get a firm grip; Avoid secondary complications; Achieving adequate reduction of bone; Immobilize the fractured area by the most appropriate technique; Achieving a functional rehabilitation of the fractured area through the restoration of no rmal forces.

Treatment: Conservative Surgery Intracapsular fractures Fixation with bone nail the tops of Smith, with or without bone graft; extracaps ular fractures Fixing the tops bone plate and nail, using in most cases the technique of Mc Lau ghlin. COMPLICATIONS Thromboembolism -It is most frequent complications a of Complications neurocircularórias - may occur due to direct trauma or by increased tissue press ure. This type of fracture causes bleeding into the interior tissue edema with i ts excessive.

Hypovolemic shock Complications Lung - The deep breathing exercises and changes in position can help in preventi ng the development of these complications Ulcers Pressure - The prevention of pressure sores should be a major concern of nurses. Must meet the skin care, especially in areas of higher pressure, you must also meet the placement and use of suitable material helps to reduce the risks electr olyte dehydration occurs easily leading to electrolyte imbalance, there is also an increase in confusion Balance Incontinence bladder - should be avoided systematic use of indwelling urinary catheter for lo ng periods because there is a higher risk of incidence of urinary tract infectio ns when performing this procedure continuously Problems Intestinal Infection

- Aseptic care pre, intra and postoperative should be strict, because the bone t issue, the material introduced or the presence of a hematoma, are highly likely to infect Consolidation - The impairment of vascularization, the posterior commi nution and osteoporosis are determinants of this complication Absence • Avascular necrosis - is common in fractures of the femoral neck. Is related to the interruption of the vasculature during the trauma or treatment. Revasculari zation is slow, hence the importance of adequate reduction and fixation of the f racture • Wear effective disassembly and material for bone NURSING CARE Preoperative Preparation Psychological-Explain procedures to patient-Keep the patient calm Physical Pre paration-Fasting 8am-Trichotomy-Supine position-evaluate vital signs, check the process of the patient NURSING CARE Postoperative Pain-related fracture, soft tissue damage, muscle spasm and surgery, mental conf usion and disorientation related to age, stress trauma, medication, unfamiliar e nvironment and surgical-wound change patterns of urinary elimination related to immobility in bed -Decline in physical mobility related to the fracture and to s tay in bed Preparation for the High evaluate the domiciliary environment, express concerns, assess the availability and physical assistance; Understanding of family and carers; guidelines for health professionals outworke rs; Advise the patient on post-hospital; Explain that you should leave the bed of the opposite side for better support; Advise the patient to the use of materials and care to avoid sharp bending of th e hip. END Presentation made by: Amelia Antunes Catarina Carvalho Coelho Carla Celeste Davis