Neck of Femur Fractures

So NOF’s aren’t the most glamorous of topics to cover on a podcast, but the difference we can make to patients but refining our care is huge.

Neck of femur fractures have a high and increasing incidence. They occur predominantly in frail patients who have the greatest risk of complications, both from the injury and medical interventions.

In this episode we’ll be running through their presentation, discuss both the clinical and radiological diagnostics. We’ll also be looking in depth about both pharmacological and non-pharmacological methods of pain relief and have a think about where fascia-iliaca compartment blocks sit with regards to pre and in- hospital practice.

Finally we’ll move on to the definitive surgical approach and in-hospital care.

Once again we’d love to hear any comments or questions either via the website or social media.


Simon, Rob & James

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RCEMLearning; fractured neck of femur

NICE; hip fracture management (updated Jan 2023)

BOAST; Patients Sustaining a Fragility Hip Fracture

The sensitivity of CT scans in diagnosing occult femoral neck fractures. Z Sadozai. Injury. 2016

BestBets; CT vs. MRI in the occult hip fracture

Fascia iliaca compartment block. N.O’Reilly. BJAEducation. 2019

Sensory Innervation of the Hip Joint and Referred Pain: A Systematic Review of the Literature. Pierre Laumonerie. Pain Med. 2021

Fascia Iliaca Compartment Block: An Update. Jonathan Major. WFSA. 2023

Comparison of USG-guided or landmark approach fascia iliaca compartment block for positioning in elderly hip fracture patients with spinal anesthesia: a randomized controlled observational study. Tuna Ertürk. Turk J Med Sci. 2021

An integrative comparative study between ultrasound-guided regional anesthesia versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: A systematic review and meta-analysis. Hany A. Zaki. Heliyon. 2022

Fascia iliaca block for pain relief from proximal femoral fracture in the emergency department: a review of the literature. Adam Chesters. EMJ. 2013

Management of an isolated neck-of-femur fracture in an elderly patient. Georgette Eaton. Journal of Paramedic Practice. 2013

Prehospital management of lower limb fractures. C Lee. EMJ. 2005

Screening tool for identification of hip fractures in the prehospital setting. Danielle M Gillette. OTA Int. 2021



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