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Flying after a femoral neck fracture

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Flying after a femoral neck fracture

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Travelling, whether for business or pleasure, does not just mean gathering new impressions and experiences. It is also a change of environment that can be more physically demanding than is the case at home. Often, a journey involves navigating and moving our bodies in unfamiliar territory, and this can have dire consequences under certain circumstances. For example, a fall in which the person sustains a hip fracture. A poorly constructed pavement can be enough to cause this.

What is a femoral neck fracture?

The femur (thigh bone) is the long bone that extends upwards from the knee joint. At the top, it becomes the femoral neck, on which the femoral head (ball joint) is located. This fits into a socket (acetabulum) of the pelvic bone. In the event of a fall, the short neck piece between the bone shaft and the femoral head can break under certain circumstances.

femoral neck fracture

In fact, the thigh bone is very strong, and it takes a violent impact to break it. However, in the course of a lifetime, human bone density can change, and a condition can develop that often goes unnoticed – osteoporosis. The reason for this is mainly calcium deficiency, as a result of which the body extracts calcium from the bone structure in order to make it available to the muscles, for example. It is easy to get the daily calcium requirement for an adult of around one gram, just from the food we eat. For example, two slices of cheese, two slices of wholemeal bread or two glasses of mineral water per day are sufficient. However, if osteoporosis has already developed, calcium alone is no longer sufficient.

Osteoporosis is a common disease of ageing, which is why a good 90% of hip fractures occur in people over the age of 65. The reason why the femoral neck breaks so often, rather than other bones, is because, when falling, a person often turns onto their side as a reflex and the femoral neck receives the full impact without being able to react flexibly, like the arms that can cushion a fall. In 2018, almost 80,000 people in Germany alone had an accident that resulted in a femoral neck fracture.

Hip fractures – better treated in your home country

Anyone who suffers a femoral neck fracture on a holiday or business trip due to a fall or perhaps a car accident, should, after initial treatment, ask to be moved to their home country, i.e. to England, Scotland, or Wales.

Ambulance jet

It is not so much that medical care is not as good in the host country compared to the patient’s home country. That is not necessarily the case. Rather, precisely because these patients tend to be older, treating a femoral neck fracture involves replacing the femoral head and neck with a prosthesis – in other words a hip replacement – although it is actually the thigh bone that is partially replaced. It is important that the follow-up care and treatment is carried out by a doctor who has been familiar with the accident and injury from the beginning. In addition, a femoral neck fracture requires the patient to stay in hospital for at least 12 days. If there are complications, for example due to advanced osteoporosis, the patient's hospital stay may be extended by weeks or even months. For a patient in a hospital where the medical staff speak a foreign language, where friends and relatives are often thousands of miles away and the food is not what they are used to at home, recovering back to full health becomes all the more difficult. Accordingly, a medical repatriation is often a sensible idea. But how exactly does a medical repatriation work?

What means of transport are available?

In principle, the transport of patients is concerned with two factors: Speed and the protection of the patient. This immediately excludes two modes of transport,  by rail and by boat, because both involve long journey times and complicated transport routes. Thus, only road and air remain:

When deploying a ground ambulance as the only means of transport for a medical repatriation, it is usually only used for short journeys, for example, for a drive of a few kilometres across the border. However, for longer distances, the risks of traffic delays on the road are too great and an ambulance is simply too slow compared to an aircraft to make it a serious option. By contrast, an ambulance is usually essential for transporting the patient from the hospital to the airport and vice versa.

Helicopters can also only be used for short distance patient transport. The great advantage of being able to take off and land directly at the hospital outweighs the disadvantages of high fuel consumption and intense demands made on the pilots. Furthermore, flying in an ambulance helicopter must still be economically viable. There are helicopters available that have longer ranges and more cabin space. However, these are also much more expensive to buy and maintain and are therefore not  financially viable in relation to the level of demand.

A patient repatriation flight on a scheduled airliner is possible for patients with a femoral neck fracture, but only if they are transported lying down. If the airline agrees, a stretcher – a special patient bed for aircraft – can be installed in the passenger cabin. However, transport in a scheduled airliner is only the right choice if the patient needs to travel only short distances to and from the airport.

An ambulance jet is the best choice for long-distance international medical repatriations. Ambulance jets can even handle intercontinental flights and, due to their smaller size compared to a passenger jet, can also land at small airports. In virtually every country of the world these are much more numerous than the busy international airports. Ambulance jets can be adapted to meet any requirements regarding patient care, and can be flexible regarding the weather and take-off and landing conditions.

What is the cost of a medical repatriation?

If there are no additional complications, which might be the case for older patients, transporting a patient with a femoral neck fracture is relatively easy in terms of stabilisation, monitoring and medication. Nevertheless, precautions must be taken, because during the transport flight conditions change constantly. The attending medical staff must be able to react to this.

Of course, this is only one cost factor among many others. In addition, there is the distance between the hospital abroad and the hospital near home and their respective locations. All the elements must also be adapted to suit each individual case and must be organised very quickly. That is why it is not possible to give a price quotation for a medical repatriation without knowledge of particular factors relating to costs. In any case, before travelling, it is always advisable to take out a travel insurance policy that includes adequate health insurance and the option of medical repatriation.

What is clear, however, is that a private individual without any knowledge and experience cannot be expected to organise a medical repatriation themselves.  Fortunately, there are specialists like us, Deutsche-Auslandsrückholung, to take care of that. We have been doing this for many years and organise repatriation flights from all over the world, even from crisis zones.

Contact us now

Our 24-hour service is always available for a free consultation. We can explain all the options for a medical repatriation for a patient with a femoral neck fracture. Contact us now: