Oberschenkelhalsbruch im Alter: Behandlung & Pflege

A femoral neck fracture, also known as a hip fracture, is a break in the area of the femoral neck — the connection between the femoral head (hip head) and the femoral shaft. This area is particularly susceptible to fractures as it is subjected to high mechanical stress.

In Switzerland, around 10,000 people suffer a femoral neck fracture each year. About 75% of those affected are over 70 years old and predominantly women. The main reason: osteoporosis. Age-related bone loss makes the bones porous and brittle, so that even a minor fall — such as when getting up or stumbling — can lead to a fracture.

Typical symptoms of a femoral neck fracture are severe pain in the hip and groin, inability to bear weight on the affected leg, shortening and outward rotation of the leg, and severe restriction of movement.

A femoral neck fracture is usually treated surgically. The type of surgery depends on various factors: the location and severity of the fracture, the age and general condition of the patient, and pre-existing conditions.

Surgical procedures

• Osteosynthesis (screw fixation): In younger patients or stable fractures, the bone is fixed with screws or nails. The aim is to preserve the natural hip joint
• Partial prosthesis (hemiarthroplasty): In older patients, the femoral head is often replaced with an artificial joint. The procedure is less invasive and enables faster mobilisation
• Total prosthesis (hip replacement): In cases of pre-existing arthritis, the entire hip joint is replaced with a prosthesis

Surgery should ideally take place within 24-48 hours of the fracture. Prompt treatment reduces complications such as thrombosis, pneumonia, and pressure ulcers (decubitus) and significantly improves the chances of healing.

Rehabilitation after a femoral neck fracture ideally begins on the first day after surgery. The goal is to restore mobility as quickly as possible and promote independence.

Phases of rehabilitation

• Early phase (hospital): Initial mobilisation with physiotherapy, getting up and walking with walking aids, pain management
• Inpatient rehabilitation: Intensive physiotherapy and occupational therapy over 2-4 weeks in a rehabilitation clinic. Training in walking, climbing stairs, and everyday activities
• Outpatient follow-up: Continuing physiotherapy, gradual increase in weight-bearing and strength. Can last several months

Important for rehabilitation

• Early and regular mobilisation is crucial for successful healing
• Fall prevention: remove trip hazards, install grab bars, wear non-slip shoes
• Osteoporosis treatment: medication, vitamin D, and calcium to strengthen bones
• Patience: full recovery can take 3-6 months or longer

After discharge from the rehabilitation clinic, many patients still need support in everyday life. Family members often take over care and support at home. The following points are important:

• Home adaptation: Remove door thresholds, install grab bars in bathroom and toilet, attach handrails to stairs, ensure adequate lighting
• Aids: Organise a walker, walking stick, raised toilet seat, shower chair, and possibly a care bed
• Medication management: Take pain medication and osteoporosis medication regularly
• Nutrition: Calcium- and vitamin D-rich diet to support bone healing
• Encouraging movement: Carry out daily exercises according to the physiotherapy plan, go for walks

Home care after a femoral neck fracture is demanding and time-intensive. As a family caregiver, you are entitled to various support services, including a care salary and respite options.