Femoral Neck Fracture (Hip)
Description
This is a break of the femoral neck — the narrow part of the thighbone just below the ball of the hip. It is uncommon in children and is taken seriously, usually following a major force such as a fall from a height or a car crash.
How it happens (the mechanism)
A high-energy force shears across the narrow neck of the femur and breaks it. The reason this break is treated urgently lies in the blood supply: the vessels that feed the ball of the hip travel up along the neck, fairly exposed, so a displaced fracture can pinch or tear them. Restoring the alignment promptly takes pressure off those vessels and gives the ball of the hip the best chance to keep its blood supply and heal.
What matters
The main concern is the blood supply to the ball of the hip. If it is lost, the bone can soften and collapse (avascular necrosis), which is the chief cause of long-term trouble after this injury. That is why a femoral neck fracture is usually treated as an urgent matter — realigned and fixed soon after the injury — and then followed with X-rays for a year or more to confirm the hip is healthy.
Symptoms
Severe hip or groin pain after a significant injury, an inability to bear weight, and a leg that may look shortened or turned out.
Doctor examination and imaging
The doctor examines the hip and the leg’s circulation and feeling; X-rays show the fracture, and additional imaging is sometimes used to plan treatment.
Treatment
Most are treated surgically, often soon after the injury, to realign the bone and hold it with screws or a small plate, sometimes relieving pressure within the joint. Younger children may also be protected in a cast. Close, extended follow-up watches healing and the health of the ball of the hip.
Recovery and long-term outlook
With prompt, accurate treatment most heal well. Because of the blood-supply concern, these are followed longer than most fractures so any problem is caught and addressed early.
When to call the doctor
Seek prompt care for severe or worsening hip, thigh, or knee pain, an inability to move or bear weight on the leg, or a foot that becomes numb, pale, or cold. Remember that pain felt at the knee can actually come from the hip, so a limping child with knee pain deserves to have the hip checked.
Learn more
OrthoInfo (AAOS) — Thighbone (Femur) Fractures in Children: orthoinfo.aaos.org
This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.