Key Points to Consider During Femoral Neck Fracture Recovery

Fractures of the femoral neck are prevalent among the elderly and can lead to a heightened risk of disability. While there are effective treatment methods available, restoring function after such a fracture is crucial for achieving optimal results.

1. Rehabilitation Principles for Femoral Neck Fracture Recovery

1.1 Goals of Rehabilitation

To effectively recover from a femoral neck fracture, rehabilitation should focus on the following objectives:

• Restoring the range of motion in the hip joint.
• Strengthening the muscles in the hip, pelvis, and buttock regions.
• Helping the patient regain their normal gait.
• Facilitating a return to regular activities and daily routines.
• Minimizing complications arising from prolonged immobility.

1.2 Rehabilitation Measures

After Bone Fusion Surgery
The primary aim of rehabilitation following bone fusion surgery is to prevent complications associated with extended bed rest, such as pneumonia, pressure ulcers, blood clots, and pain. Additionally, it helps maintain joint mobility, prevent muscle atrophy and stiffness, and restore muscle strength.

Rehabilitation methods include:

• Heat therapy to warm the muscles of the thighs and hips, using techniques like warm compresses.
• Vibration to loosen phlegm and reduce the risk of pneumonia.
• Regular changes in lying positions to avoid pressure ulcers.
• Early joint movement, starting around 3 days after surgery. This includes active or passive movements with assistance from medical professionals or caregivers. Specific exercises involve stretching the hip and knee joints for about 45 seconds, repeated 10 to 15 minutes, 4-6 times a day. Ankle joint exercises are also beneficial, particularly instep flexion.
• Increasing muscle strength through knee flexion exercises or static muscle contractions (contractions without movement). Patients lying on their back can perform these exercises, holding each contraction for about 5 to 10 seconds, and repeating them 10 to 15 times. Early exercises are essential to prevent muscle atrophy.
• Learning to walk with crutches within the first 6 months. Patients should use wooden crutches, keeping the bar across the top of the crutches resting on the side of the chest. While walking, they should maintain an upright posture with eyes looking straight ahead and shoulders level. After 6 months, they can gradually shift to walking with partial body weight support, eventually phasing out the use of crutches.
• Once the bones have healed solidly, practicing movements like standing up, sitting down, and climbing stairs. It is crucial to monitor the health status and exercise at a reasonable pace.

After the cast is removed, patients can typically begin walking with crutches within 24 to 48 hours. This helps strengthen the muscles in the hip and thigh regions. Rehabilitation methods are similar to those after bone fusion surgery.

After Hip Replacement Surgery

• Rehabilitation exercises after hip replacement surgery are akin to those after bone fusion. However, patients can start walking with crutches or a walker earlier, and their recovery tends to be faster.
• From the 4th week post-surgery, patients can progress to normal walking and exercises to strengthen muscles, such as stationary cycling, gradually increasing intensity based on endurance.

2. Important Notes for Femoral Neck Fracture Rehabilitation

Rehabilitation exercises play a vital role in increasing blood circulation, muscle relaxation, pain reduction, and preventing long-term lying, muscle atrophy, and stiffness.

Important considerations:

• Begin rehabilitation exercises as early as possible, as delayed treatment may lead to joint atrophy and hinder the recovery process.
• Gradually increase the frequency and intensity of exercises according to endurance and adhere to the prescribed regimen to prevent injuries.
• Focus on exercises that strengthen muscles and improve joint mobility.
• Avoid using or applying products of unknown origin.
• Avoid crossing the surgical leg over the healthy leg.
• Do not sit with the hip flexed more than 90 degrees.
• Refrain from inwardly rotating the surgical leg.
• Avoid bending the thighs too much toward the stomach or excessively curving the back, leading to an angle of less than 90 degrees between the thighs and torso.
• Utilize chairs with armrests to facilitate ease of getting up.
• When using the toilet, opt for a higher seat to prevent bending the thighs more than 90 degrees.