Delayed diagnosis of femoral neck fracture: A case report and literature review
Year: 2025
Type: article
Study design: Case Report
Abstract: Femoral neck fractures are common in elderly resulting from minor trauma. In resource limited settings, these fractures are sometimes missed in radiographic interpretation which delays the treatment and chance of morbidity and mortality increases. We report the case of a 72-year-old male who presented to a primary healthcare facility with complaints of pain in the left hip and lower back following a fall. He was misdiagnosed with a soft tissue injury and managed conservatively with pelvic traction. Due to persistent symptoms and inability to bear weight, he sought a second opinion six days later. Repeat radiography at our center revealed a displaced femoral neck fracture (Garden Type IV). Given the patient's age, delayed presentation, and poor socioeconomic condition, uncemented hemiarthroplasty using an Austin Moore prosthesis was performed via the Hardinge (direct lateral) approach. Postoperative recovery was uneventful, and the patient was mobilized early with a walker and discharged on postoperative day seven. Femoral neck fractures, especially non-displaced or minimally displaced types, can be easily missed in elderly patients without a high index of clinical suspicion. Early and accurate diagnosis is essential to prevent complications like avascular necrosis and nonunion. Socioeconomic limitations can delay advanced imaging and definitive care. This case highlights the importance of thorough clinical evaluation, repeat imaging in persistent cases, and early referral to specialized centers. Delayed diagnosis of femoral neck fracture in the elderly can result in displacement and poorer outcomes if not appropriately managed. • Femoral neck fractures are common in the elderly and can be missed, especially in resource-limited primary healthcare settings. • This case highlights a delayed diagnosis of a femoral neck fracture in a 72-year-old male initially misdiagnosed with soft tissue injury. • Repeat imaging after persistent symptoms revealed a displaced Garden Type IV femoral neck fracture. • The patient was successfully managed with uncemented hemiarthroplasty using an Austin Moore prosthesis via the Hardinge approach. • Early suspicion, appropriate imaging, and timely referral are essential to prevent complications like nonunion and avascular necrosis. • Socioeconomic limitations can affect timely diagnosis and imaging; clinical judgment plays a key role in such cases.
Institution: Janaki Medical College
Language: English
Topic: Hip and Femur Fractures
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W4414478117