La Consolacion College Manila

A Case Study On

Femoral Neck Fracture

Submitted by: Avenado, Ivan L. Calilao, Volteir Estalilla, Jesska T. Lee, Janine Kaila Millan, Jenina Junne U. Pichay, Ann Margarette T. Villalobos, Marlon BSN 41

Submitted to: Sir Christopher Lor Clinical Instructor Bahay Consuelo

Submitted on: July 17, 2013 1st Semester S.Y 2013-2014

I. Introduction A fracture, also referred to as a bone fracture, FRX, FX, Fx or #, is a medical condition where the continuity of the bone is broke. A significant percentage of bone fractures occur because of high force impact or stress; however, a fracture may also be the result of some medical conditions which weaken the bones, for example osteoporosis, some cancers or osteogeneris imperfecta. A fracture caused by a medical condition is known as a pathological fracture. A hip fracture is a femoral fracture that occurs in the proximal end of the femur (the long bone running through the thigh), near the hip. The term "hip fracture" is commonly used to refer to four different fracture patterns and is often due to osteoporosis; in the vast majority of cases, a hip fracture is a fragility fracture due to a fall or minor trauma in someone with weakened osteoporotic bone. Most hip fractures in people with normal bone are the result of high-energy trauma such as car accidents, or cycling accidents. Femoral neck fractures involve the narrow neck between the round head of the femur and the shaft. This fracture often disrupts the blood supply to the head of the femur. Often, a fractured hip is a catastrophic event that will have a negative impact on the patients life style and quality of life. There are two major types of hip fracture. Intracapsular fractures are fractures of the neck of the femur, Extracapsular fracture are fractures of the trochanteric region and of the subtrocanteric region. Fractures of the neck of the femur may damage the vascular system that supplies blood to the head and theneck of the femur, and the bone may die. British orthopaedic surgeon Robert Symon Garden described a classification system for this type of fracture, referred to as the Garden classification and consisting of four grades: Type 1 is a stable fracture with impaction in valgus. Type 2 is complete but non-displaced. Type 3 is partially displaced (often externally rotated and angulated) with varus displacement but still has some contact between the two fragments. Type 4 is completely displaced and there is no contact between the fracture fragments.

The blood supply of the femoral head is much more likely to be disrupted in Garden types 3 or 4 fractures. Surgeons may treat these types of fracture by replacing the fractured bone with a prosthesis arthroplasty. Alternatively the treatment is to reduce the fracture (manipulate the fragments back into a good position) and fix them in place with metal screws. Common practice is to use repair Garden 1 and 2 fractures with screws, and to replace Garden 3 and 4 fractures with arthroplasty, except in young patients in whom screw repair is attempted first, followed by

arthroplasty if necessary. This is done in an effort to conserve the natural joint since prosthetic joints ultimately wear out and have to be replaced.

II. Objectives General Objectives: After two weeks of nurse-patient interaction, the patient was able to gain knowledge, skills, and a positive attitude regarding her femoral neck fracture. Specific Objectives: A. STUDENT-NURSE CENTERED After 8 hours of student nurse-patient interaction, the student nurse will be able to: 1. Identify the history of the patient. 2. Assess the affected parts of the fracture. 3. Identify the signs and symptoms of the condition. 4. Create and Implement Nursing Care Plans for the patient. 7. Give health teachings to the patient. B. PATIENT-CENTERED After 8 hours of student nurse-patient interaction, the patient will be able to: 1. Practice the different kinds of range of motion exercises. 2. Know the specifics of her condition. 3. Explain the short-term and long term goals of her on-going treatment