11. Hip Fractures

Question 1

Risk factors and most common:

Answer 1

Risks: Women, increased age
Most common: NOF, fractured neck of femur. Fracture between femoral head and greater and lesser tronchanters of the femur.

Question 2

Aetiology

Answer 2

Falling: From same level e.g tripping
External trauma: Generally car accidents.
Bone weakness or degeneration: Osteoporosis or osteoarthritis.

Question 3

Diagnosis

Answer 3

X-ray first, then CT scan which is more obvious

Question 4

Co-occurring conditions:

Answer 4

Osteoporosis, osteoarthritis, diabetes, CVD, respiratory issues.

Question 5

What are the three types of hip fractures?

Answer 5

Subcapital: Femoral head/neck junction. Danger of compromise blood supply to head of femur. THR.
Transcervical: Mid portion of femoral neck. Generally screw or THR.
Intertrochanteric: Base of femoral neck. Generally pin and plate.

Question 6

Type of treatment depends on:

Answer 6

Age, level/severity of fracture, bone density, co-morbidites, quality of life.

Question 7

What is hemiarthroplasty, dynamic hip screw and intramedullay nail?

Answer 7

Hemiarthroplasty: Replacement of head of femur of the acetabulum, common in younger patients
Dynamic hip screw: Long screw into head and neck of femur, plate fixated on upper shaft of femur
Intremedullary nail: Long nail is place down narrow of the femur shaft.