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S72.0 – Femoral Neck Fracture: Causes & Treatment
S72.0 is the ICD-10 code for a fracture of the neck of the femur. This common injury mainly affects older adults and often requires surgical treatment.
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S72.0 is the ICD-10 code for a fracture of the neck of the femur. This common injury mainly affects older adults and often requires surgical treatment.
What is S72.0?
S72.0 is the diagnostic code under the International Classification of Diseases (ICD-10) for a fracture of the neck of the femur – a break in the narrow section of bone that connects the shaft of the thighbone (femur) to the femoral head (the ball of the hip joint). This type of fracture is one of the most common and clinically significant injuries in older adults.
Causes
The most frequent cause of a femoral neck fracture is a fall from a standing height, particularly in elderly individuals with underlying osteoporosis (reduced bone density). In younger patients, high-energy trauma such as road traffic accidents or falls from heights are more typical. Key risk factors include:
- Osteoporosis and reduced bone mineral density
- Advanced age (especially over 70 years)
- Female sex (increased osteoporosis risk after menopause)
- Increased fall risk due to balance disorders, medications, or visual impairment
- Nutritional deficiencies (e.g., calcium and vitamin D)
Symptoms
Typical signs of a femoral neck fracture include:
- Severe pain in the hip or groin area, worsening with movement or weight-bearing
- Inability to stand or walk
- Shortening and external rotation of the affected leg (the leg appears shorter and rotated outward)
- Swelling and possible bruising around the hip
- Tenderness over the greater trochanter
Diagnosis
Diagnosis is typically established through:
- X-ray imaging of the hip in two planes (standard first-line investigation)
- Computed tomography (CT) for ambiguous findings or detailed fracture classification
- Magnetic resonance imaging (MRI) to detect occult (hidden) fractures not visible on X-ray
In addition to imaging, the overall health status, comorbidities, and bone quality of the patient are assessed. A widely used classification system is the Garden classification (Grade I–IV), which describes the severity of displacement and the vascular integrity of the femoral head.
Treatment
Treatment of a femoral neck fracture is in most cases surgical. The choice of procedure depends on patient age, fracture pattern, and general health status:
Surgical Options
- Osteosynthesis (internal fixation): Realignment and fixation of the bone fragments using screws or an intramedullary nail. Preferred for younger patients with good bone quality and non-displaced or minimally displaced fractures.
- Hemiarthroplasty: Replacement of the femoral head with a prosthetic implant. Commonly used in elderly patients with displaced fractures.
- Total hip arthroplasty (THA): Full replacement of the hip joint. Preferred in active older patients with pre-existing hip osteoarthritis.
Conservative Management
Non-surgical management is considered only in rare cases – for example, in patients who are not fit for surgery and have a stable, impacted fracture.
Rehabilitation
Early mobilization and physiotherapy after surgery are essential to prevent complications such as deep vein thrombosis, pneumonia, and pressure sores. Comprehensive geriatric rehabilitation supports recovery and return to independent living.
Prognosis and Complications
Femoral neck fractures are associated with significant morbidity and mortality: up to 20–30% of affected elderly patients die within one year after the injury, often due to complications and underlying conditions. Possible complications include:
- Avascular necrosis of the femoral head (bone tissue death due to impaired blood supply)
- Non-union (failure of the bone to heal properly)
- Prosthesis loosening or infection
- Deep vein thrombosis and pulmonary embolism
- Permanent loss of mobility and need for long-term care
References
- Meinberg EG, Agel J, Roberts CS et al. – Fracture and Dislocation Classification Compendium – 2018. Journal of Orthopaedic Trauma, 2018;32(Suppl 1):S1–S170.
- National Institute for Health and Care Excellence (NICE): Hip fracture: management. Clinical guideline [CG124], 2011 (updated 2023). Available at: www.nice.org.uk
- World Health Organization (WHO): ICD-10 Version 2019, Code S72.0 – Fracture of neck of femur. Available at: https://icd.who.int/browse10/2019/en#/S72.0
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