Nonoperative treatment
1. General considerations
Treatment guidelines
Nonoperative treatment consists of skin traction on the leg for a few days and early mobilization.
Reduction of the hip
After closed reduction of the hip, x-ray evaluation of the reduction is necessary.
2. Skin traction
If desired, skin traction over the end of the bed with 2 kg may be the initial treatment.
3. Mobilization
Dislocation precautions
Since most femoral head fractures are associated with a hip dislocation, precautions against redislocation should be taken for the first 6 weeks after injury.
Low seats and toilets, flexing the hip when arising, sitting with legs crossed, as well as squatting and kneeling may also be avoided initially, as should pivoting on the affected leg. The patient and caregivers may be encouraged to use additional support when rising from a sitting position.
Postoperative mobilization
Mobilization starts as soon as pain is tolerable with walking aids.
4–6 weeks after injury, full weight bearing can be started.
Functional treatment is continued until fracture healing.
In case of secondary displacement, treat the fracture like a primarily displaced fracture.
