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Year 2 Medicine @ Lancaster Uni > 2.09 - Hip Fractures, Surgery and DVT > Flashcards

2.09 - Hip Fractures, Surgery and DVT Flashcards

1
Q

What is the function and composition of ligament tissue?

A
  • Resist tension
  • Collagen I
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2
Q

What is the function and composition of tendon tissue?

A
  • Resist tension
  • Collagen I
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3
Q

What is the function and composition of cartilage?

A
  • Resist compression
  • Collagen I
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4
Q

What is the function and composition of fibrocartilage?

A
  • Resist compression
  • Collagen I + II
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5
Q

What is the function and composition of bone?

A
  • Resist compression
  • Hydroxyapatite
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6
Q

What is the function and composition of synovium?

A
  • Provide lubrication
  • Mainly cellular
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7
Q

What is the function and composition of muscle?

A
  • Relaxation and contraction
  • Myocytes
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8
Q

What is the function and structure of elastic cartilage?

A
  • Irregualar structure, Large cells
  • Type II
  • Eg. Pinna
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9
Q

What is the function and structure of hyaline cartilage?

A
  • Most common type
  • Type II collagen
  • Shock absorption
  • Provides an articular surface
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10
Q

What are the different types of bone?

A
  • Long
  • Short
  • Flat
  • Irregular
  • Sesamoid
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11
Q

What are the two strutural types of bone?

A
  • Cortical (Compact)
  • Trabecular (Spongy)
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12
Q

What are the functions of bone?

A
  • Calcium storage
  • Visceral support
  • Protection
  • System of levers
  • Possible endocrine function?
  • Haematopoiesis
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13
Q

What is the structure of woven bone?

A
  • Primary type
  • Involved in fracture repair and embryonic development
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14
Q

What is the function of lamellar bone?

A
  • Bone of the skeleton
  • Can either be compact or spongy
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15
Q

What is the extracellular matrix of bone?

A
  • Molecules that provide biochemical and structural support to the cells
  • Eg. Calcium Hydroxyapatite
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16
Q

What are the different cell types found in bone?

A
  • Osteocytes
  • Osteoclasts
  • Osteoblasts
  • Lining cells
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17
Q

What is the function of osteoblasts?

A
  • Principle function of bone formation
  • Synthesis bone matrix and ensure it is primed
  • Large cuboidal cells
  • Form an epithelial layer on the cell surface
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18
Q

What is the function of osteocytes?

A
  • Mature blast cells that are engulfed in matrix during mineralisation -> Entombed in bone matrix
  • Relied on canaliculi to maintain junctions with other entombed cells
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19
Q

What is the function of osteoclasts?

A
  • Large multinucleated cells responsible for the reabsorption of bone
  • Distinct ruffled border appearance
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20
Q

What is the function of lining cells?

A
  • Mature blast cells that can be reactivated
  • Play a role in bone remodelling
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21
Q

What is type I collagen?

A
  • Made bone proteogylcan and some other non-callagenous proteins such as osteocalcin, osteorectin, osteopontin
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22
Q

What is hydroxyapatite?

A
  • Mineral
  • Complex calcium-phosphate salt molecule
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23
Q

What is the fucntion of compact bone?

A
  • Strength
  • High density
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24
Q

What are the two types of bone ossification?

A
  • Endochondral
  • Intramembranous
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25
Q

How does intramembranous ossification occur?

A
  • Via remodelling of mesenchymal connective tissue that acts as blueprint
  • Growth occurs from inside to outside
  • Framework becomes calcified and traps osteoblasts
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26
Q

In which bones does intramembranous ossification occur?

A
  • Flat bones
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27
Q

What is the function of mesenchymal cells?

A
  • Acts as blueprint framework
  • From periosteum on the outer surface
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28
Q

How does endochondral ossification occur?

A
  • When bone forms in the place of a hyaline cartilage precursor
  • Chondrocyte death occurs in the cartilage which allows inward migration of osteoblasts
  • Involves growth plates
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29
Q

Which bones does endochondral ossification take place?

A
  • Long bones
  • Bones that utilise growth plates
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30
Q

How do bones heal?

A
  • Process of bone remodelling
  • Bone callous forms which is then reformed into mature bone
  • Can return to original form and strength
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31
Q

How do tendons repair?

A
  • Limited ability to heal
  • Has a poor blood supply which contributes to the slower healing process
  • Inflammatory process
  • Fibroblasts
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32
Q

How do muscles heal?

A
  • Have a limited ability to heal similar to tendons
  • Satellite cells (type of muscle cell) become activated and proliferate then differentiate into myoblasts
  • These fuse to form new muscles cells
  • Not returned to original strength
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33
Q

How does being elderly effect fracture incidence?

A
  • Increasing age is a ris factor for fractures
  • Due to increased incidence of osteoporosis
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34
Q

How does osteoporosis occur?

A
  • Imbalance of bone breakdown and bone formation leads to a reduction in the density of bone
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35
Q

What is osteoporosis?

A
  • Characterised by low bone mass and micro-architectural deterioration of bone
  • This results in increased fragility
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36
Q

What level of bone mass density is classed as osteoporotic?

A
  • When bone mineral density is 2.5 standard deviations below mean peak mass for their age
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37
Q

What is the epidemiology behind osteoporosis?

A
  • Affects over 2 million people in the UK
  • Prevalence increases with age
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38
Q

Which group are most at risk of osteoporosis?

A
  • Post-menopausal women
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39
Q

What are the clinical features associated with osteoporosis?

A
  • Bones that break more easily
  • Crumbly bone appearance
  • Stooped posture
  • Loss of height
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40
Q

Why does osteoporosis occur?

A
  • Increased osteoclast activity
  • Level osteoblast activity
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41
Q

How do glucocorticoids increase risk of osteoporosis?

A
  • They can stimulate increased turnover of bone which can lead to osteoporosis
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42
Q

What are the two types of risk factors seen in the development of osteoporosis?

A
  • BMD dependant
  • BMD independant
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43
Q

What are some BMD dependant risk factors for osteoporosis?

A
  • Female sex
  • Causcasian/Asian
  • CKD
  • Vitamin D deficiency
  • Chronic liver disease
  • Endocrine disorders
  • Multiple myeloma
  • Osteogenesis imperfecta
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44
Q

What are some BMD independant risk factors for osteoporosis?

A
  • Previous fragility fracture
  • FHx
  • Corticosteroids
  • Alcohol (3+ units a day)
  • Smoking
  • Low BMI
  • Rheumatoid arthritis
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45
Q

What is a low BMD associated with?

A
  • Significant increased fracture risk from low impact events such as a fall from standing height
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46
Q

What is the normal first-line treatment for osteoporosis?

A
  • Oral biphosphonates
  • Alendronate - 30 minutes before food
  • Zoledronic acid - IV injection once a year
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47
Q

How does denosumab help with the treatment of osteoporosis?

A
  • Inhibits osteoclast formation/survival
  • Type of human monoclonal antibody
  • Decreases bone resorption
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48
Q

How is raloxifene used in osteoporosis management?

A
  • Selective estrogen receptor modulator
  • Decreased bone resorption
  • Increased risk of VTE and stroke
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49
Q

What lifestyle factors can be addressed in osteoporosis?

A
  • Smoking
  • Alcohol
  • Falls assessment
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50
Q

How is hormone replacement therapy used in osteoporosis?

A
  • Form of oestrogen +/- progesterone
  • Prevention of fractures in women
  • Used in younger women
  • Multiple side effects
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51
Q

What tool can be used to assess a persons risk of fracture over a 10 year period?

A
  • FRAX
  • QFracture
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52
Q

What is the pathophysiology behind osteoporosis?

A
  • Increased osteoclast activity
  • This leads to increased breakdown of bone
  • This is unmatched by osteoblast activity
  • Bone mass decreases
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53
Q

What is investigation is used to assess bone mass density?

A
  • Dual-energy X-ray absorptiometry (DXA) scan
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54
Q

What are the meanings behind DXA scan results?

A
  • Scored with a T-score
  • > -1 = normal
  • -1 -> -2.5 = osteopenia
  • ≤ -2.5 = osteoporosis
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55
Q

What are some secondary causes of osteoporosis?

A
  • Endocrine conditions
  • Malabsorptive conditions
  • Chronic liver disease
  • Certain rheumatological conditions
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56
Q

What is the most common type of hip fracture?

A
  • NOF fracture
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57
Q

In what regions can a NOF fracture occur in?

A
  • From subcapital region of femoral head to 5cm distal to lesser trochanter
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58
Q

What is an intra-capsular NOF fracture?

A
  • From subcapital region to basocervical region of neck
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59
Q

What are the two types of extra capsular fracture?

A
  • Inter-trochanteric
  • Sub-trochanteric
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60
Q

How are NOF fractures graded?

A
  • Garden classification
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61
Q

What are the different grades in the garden classification?

A

1 - Incomplete, undisplaced
2 - Complete, undisplaced
3 - Complete, partial displaced
4 - Complete, fully displaced

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62
Q

What is the gold standard investigation for suspected NOF fractures?

A
  • Plain film radiograph
  • AP and lateral
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63
Q

What radiological feature can be used as a reference for a NOF fracture?

A
  • Shenton’s line
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64
Q

What blood test should be done in suspected NOF fractures?

A
  • CK blood test
  • To assess for rhabdomyolysis
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65
Q

What are the three parts of surgical intervention care?

A
  • Pre-operative
  • Peri-operative
  • Post-operative
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66
Q

What are the aims of the a peri-operative assessment?

A
  • Identification of significant co-mobidities
  • 2-4 weeks before surgery
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67
Q

What are the two main parts of a pre-operative assessment?

A
  • Full general examination
  • Anaesthetic examination
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68
Q

What are the blood tests conducted as part of a pre-operative assessment?

A
  • FBC
  • U&E
  • LFT’s
  • Clotting profile
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69
Q

What cardiac investigations are undertaken in a pre-operative assessment?

A
  • ECG
  • ECHO
  • Myocardial perfusion scans
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70
Q

What respiratory investigations are used in a pre-operative assessment?

A
  • Spirometry in chronic conditions
  • CXR
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71
Q

What other investigations are undertaken in a pre-operative assessment?

A
  • Urinalysis
  • MRSA swabs
  • CPET (Cardiopulmonary exercise testing)
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72
Q

What are main principles of peri-operative management?

A
  • Anaesthesia
  • Pain relief
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73
Q

What are the principles of anaesthesia?

A
  • Hypnosis
  • Analgesia
  • Muscle relaxation
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74
Q

What is the main goal of anaesthesia?

A
  • Involves the loss of feeling or sensation
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75
Q

What are the different type of anaesthesia?

A
  • General - Propofol IV
  • Regional
  • Conscious
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76
Q

What are the different types of regional anaesthesia?

A
  • Neuroaxial - Epidural/Spinal
  • Peripheral - Nerve block
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77
Q

What is the main aim of analgesia in peri-operative care?

A
  • Loss of nociception/pain response
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78
Q

What are the different types of analgesia?

A
  • Opioids
  • Opiates
  • NSAIDs
  • Paracetamol
79
Q

What are the different steps on the WHO pain relief ladder?

A
  1. Non-opioid
  2. Mild opioid
  3. Moderate/Severe opioid
80
Q

What are examples of opioids?

A
  • Fentanyl
  • Morphine
  • Tramadol
  • Oxycodone
81
Q

What is the main aim of post-operative care?

A
  • Management of pain
  • Avoidance of complications
82
Q

In which ways should pain be assessed in a post-op patient?

A
  • Mobile
  • In bed
  • On inspiration
83
Q

What are the stages of analgesia progression?

A
  1. Simple analgesics
  2. Weak opioids
  3. Strong opioids
84
Q

What drugs can be used for neuropathic pain?

A
  • Amitryptyline
  • Gabapentin
85
Q

What are the two main complications that can arise from surgical intervention?

A
  1. Pneumonia
  2. VTE
86
Q

What is pneumonia in relation in a post-op setting?

A
  • LRTI with accompanying infection on CXR
  • Most common in post-op setting
87
Q

How are post-op patients predisposed to pneumonia?

A
  • Reduced chest ventilation
  • Change in commensals
  • Debilitation (Immunocompromised etc.)
  • Intubation (VAP)
88
Q

What can help to aid in the prevention of pneumonia?

A
  • Chest physiotherapy
89
Q

How is the severity of pneumonia assessed?

A
  • CURB-65
90
Q

How is mild post-op pneumonia managed?

A
  • O2 therapy as indicated
  • Co-amoxiclav 625mg Oral
91
Q

How is moderate post-op pneumonia managed?

A
  • O2 therapy as indicated
  • Co-amoxiclav 625mg Oral
92
Q

How is severe post-op pneumonia managed?

A
  • O2 therapy as indicated
  • Tazocin 4.5g IV
93
Q

What is a VTE in a post-op setting?

A
  • Term used to describe DVT and PE
94
Q

What is Virchow’s triad in relation to VTE formation?

A
  • Abnormal blood flow
  • Abnormal blood components
  • Abnormal vessel wall
95
Q

How does a DVT usually present?

A
  • Unilateral leg swelling
  • Pain
  • Possible coldness
96
Q

What are some risk factors for the development of VTE?

A
  • Surgery
  • Obesity
  • Active malignancy
  • Smoking
  • Previous VTE
  • Increasing age
97
Q

What are the two main types of VTE prophylaxis?

A
  • Mechanical
  • Pharmacological
98
Q

What are examples of mechanical thromboprophylaxis?

A
  • Antiembolitic stockings
  • Intermittent pneumatic compression
99
Q

What are examples of pharmacological thromboprophylaxis?

A
  • LMWH
  • If poor renal function = unfractionated heparin (Enoxaparin SC injection)
100
Q

What investigations can be used in cases of DVT?

A
  • DVT Well’s score
  • D-Dimer (Specific but not sensitive)
101
Q

What investigations can be used in cases of PE?

A
  • PE Well’s score
  • D-Dimer test
  • CT pulmonary angiogram
102
Q

What is the definitive investigation for a PE?

A
  • CT pulmonary angiogram
103
Q

What are vitamin K dependant clotting factors?

A
  • 2,7,9,10
104
Q

What are the different drug groups that can be used in DVT prophylaxis?

A
  1. Anticoagulants
  2. DOACs
  3. Warfarin
  4. Antiplatelets
105
Q

What are examples of anticoagulants?

A
  • Heparins
  • LMWH
  • UFH
106
Q

How do anticoagulants work?

A
  • Prevent the formation of fibrin clots and inhibit existing clot propagation
107
Q

How does UFH work?

A
  • Increases activity of antithrombin II
  • This inactivates thrombin and factor Xa
  • Cascade is inhibited
108
Q

How does LMWH work?

A
  • Inhibits factor Xa
  • Less effect on thrombin than UFH
109
Q

How is UFH usually delivered?

A
  • Typically given via IV
110
Q

How is LMWH usually administered?

A
  • Usually given SC making in easy and convenient to give
111
Q

What monitoring is required when using anticoagulants?

A
  • UFH requires monitoring of aPTT
  • LMWH has predictable pharmacokinetics
112
Q

What are examples of DOACs?

A
  • Rivaroxaban
  • Apixaban
  • Edoxaban
113
Q

How do DOACs work?

A
  • Directly inhibit factor Xa or thrombin
  • Prevents conversion of prothrombin to thrombin
  • Therefore stopping fibrin clot formation
114
Q

How are DOACs usally administered?

A
  • Direct ORAL anticoagulants
  • Given orally with a fixed dosing regimen
115
Q

What monitoring is required with DOACs?

A
  • They have predictable pharmacokinetics therefore close monitoring not required
116
Q

How does Warfarin work?

A
  • Inhibits the synthesis of vitamin K dependant clotting factors by interfering with the recycling of vitamin K
117
Q

How does Warfarin work?

A
  • Reduces the production of clotting factors and prolongs clotting time
  • Inhibits the formation of blood clots
118
Q

How is Warfarin administered and what monitoring is required?

A
  • Administered orally
  • Requires monitoring of INR to ensure therapeutic efficacy and prevent complications
119
Q

What are the limitations around the use of Warfarin?

A
  • Slow onset of action
  • Numerous food and drug interactions
120
Q

What are the uses of antiplatelet drugs?

A
  • Used for prophylaxis of cardio/cerebrovascular events
  • Also used in ACS and in post-stroke/TIA management
121
Q

How does aspirin work?

A
  • Prevents the conversion of collagen into thromboxane
122
Q

How do Clopidogrel, Ticagrelor etc. work?

A
  • Work by preventing ADP activation of GP IIb/IIa
123
Q

What are some adverse events that are associated with antiplatelet therapy?

A
  • Excess bleeding GI or Intracranial
  • Aspirin induced asthma
124
Q

What is the function of the lumbosacral plexus?

A
  • Provides both motor and sensory nerve supply to the lower limb and pelvis
125
Q

What vertebral levels are involved in the lumbosacral plexus?

A
  • T12 - L5
126
Q

What is the most common cause of damage to the lumbosacral plexus?

A
  • Spinal disc herniation
127
Q

Where do the branches of the lumbar plexus stem from?

A
  • Anterior rami of spinal roots L1-L4
128
Q

What are the branches of the lumbar plexus?

I I Get Leftovers On Fridays

A

Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral
Obturator
Femoral

129
Q

What is the function and origin of the iliohypogastric nerve?

A
  • 1st major branch
  • L1
  • Motor = int. oblique and trans. abdominus
  • Sensory = posterolateral gluteal skin
130
Q

What is the function and origin of the ilioinguinal nerve?

A
  • 2nd major branch
  • L1
  • Motor = int. oblique and trans. abdominis
  • Sensory = skin on anteromedial thigh and external sexual organ sensation
131
Q

What is the function and origin of the genitofemoral nerve?

A
  • After leaving psoas major, splits into two branches
  • L1 and L2
  • Motor = Cremasteric muscle
  • Sensory = thigh and sexual organ sensation
132
Q

What is the function and origin of the lateral femoral cutaneous nerve?

A
  • L2 and L3
  • Motor = N/A
  • Sensory = Innervates the ant/lat thigh down to level of the knee
133
Q

What is the function and origin of the obturator nerve?

A
  • Major peripheral nerve of lower limb
  • L2, L3, L4
  • Motor = Muscles of medial thigh
  • Sensory = Innervates skin over medial thigh
134
Q

What is the function and origin of the femoral nerve?

A
  • Largest branch of lumbar plexus
  • L2, L3, L4
  • Motor = Muscles of anterior thigh
  • Sensory = Skin on anterior thigh and medial leg
135
Q

What is the function of the sacral plexus?

A
  • Skin and muscles of the pelvis and lower limb
136
Q

Which verterbral levels are involved in the sacral plexus?

A
  • L4 - Co1
137
Q

What are the major nerves of the sacral plexus?

Some Irish Sailor Pesters Polly

A

Superior Gluteal
Inferior Gluteal
Sciatic
Posterior cutaneous
Puedendal

138
Q

What is the function and origin of the superior gluteal nerve?

A
  • Leaves via sciatic foramen
  • L4, L5, S1
  • Motor = Gluteus minimus/medius and tensor fascia latae
  • Sensory = N/A
139
Q

What is the function and origin of the inferior gluteal nerve?

A
  • L5, S1, S2
  • Motor = Gluteus maximus
  • Sensory = N/A
140
Q

What are the two divisons of the sciatic nerve?

A
  • Tibial
  • Common fibular
141
Q

What are the nerve roots of the sciatic nerve?

A
  • L4, L5, S1, S2, S3
142
Q

What is the motor function of the tibial nerve?

A
  • Muscles of posterior thigh
  • Hamstring component of adductor magnus
  • Muscles of posterior leg and foot
143
Q

What is the motor function of the common fibular nerve?

A
  • SH of biceps femoris
  • Muscles of anterior/lateral thigh
  • Extensor digitorium brevis
144
Q

What is the sensory fucntion of the tibial nerve?

A
  • ## Supplies skin of posterolateral leg, lateral foot and sole of the foot
145
Q

What is the sensory function of the common fibular nerve?

A
  • Skin of lateral leg
  • Dorsum of foot
146
Q

What is the function and origin of the posterior femoral cutaneous?

A
  • S1, S2, S3
  • Motor = N/A
  • Sensory = Skin of posterior thigh and leg
  • Skin of perinuem
147
Q

What is the function and origin of the pudendal nerve?

A
  • S2, S3, S4
  • Motor = Innervates skeletal muscle of perineum, external sphincters and the levator ani muscle grouop
  • Sensory = Innervates penis/clitoris and skin of perineum
148
Q

Other than the five major branches, what are the other branches of the sciatic plexus?

A
  • Nerve to Piriformis
  • Nerve to obturator internus
  • Nerve to quadratus femoris
149
Q

What are the muscles of the anterior thigh?

A
  • Iliopsoas
  • Sartorius
  • Quadriceps femoris
  • Pectineus
150
Q

What is the origin and attachment of the iliopsoas muscle?

A
  • Arises from pelvis and passes under the inguinal ligament
  • From lumbar vertebrae and iliac fossa -> Lesser trochanter of femur
151
Q

What is the action of the iliopsoas?

A
  • Flexion of the hip joint and thigh
152
Q

Which muscles make up the quadriceps femoris?

A
  • Vastus lat/int/med
  • Rectus femoris
153
Q

What is the action of the quadriceps femoris group?

A
  • Extension and stabilisation of knee joint
154
Q

What are the attachments of the sartorius muscle?

A
  • From ASIS -> superior medial surface of tibia
155
Q

What is the action of the sartorius?

A
  • At hip joint it is a flexor, abductor and lateral rotator
  • At knee joint is is a flexor
156
Q

What are the attachments of the pectineus?

A
  • From pectineal line of pubis bone -> Posterior aspect of femoral shaft
157
Q

What is the action of the pectineus muscle?

A
  • Adduction/Flexion at the hip joint
158
Q

Which nerves supplies the muscles of the anterior thigh?

A
  • Femoral nerve
159
Q

Which artery supplies the muscles of the anterior thigh?

A
  • Femoral artery
160
Q

What are the muscles found in the medial compartment of the thigh?

A
  • Gracilis
  • Adductor brevis/longus/magnus
  • Obturator externus
161
Q

What is the action of adductor longus?

A
  • Thigh adduction
162
Q

What are the attachments of the adductor longus?

A
  • From pubis -> linea aspera of femur
163
Q

What are the attachments of the adductor brevis?

A
  • Body of pubic and inferior pubic rami -> Linea aspera (Proximal to longus)
164
Q

What is the action of adductor brevis?

A
  • Adduction of the thigh
165
Q

What are the attachments of the obturator externus?

A
  • From obturator foramen -> greater trochanter
166
Q

What is the action of the obturator externus muscle?

A
  • Adduction and lateral rotation of the thigh
167
Q

What are the attachments of the gracilis?

A
  • From pubis -> Medial femoral shaft
168
Q

What is the action of the gracilis muscle?

A
  • Adduction of the thigh and flexion of leg at knee
169
Q

What are the two parts of the adductor magnus muscle?

A
  • Adductor
  • Hamstring
170
Q

What are the attachments of the adductor portion of the adductor magnus?

A
  • Pubis and ischium -> Linea aspera of femur
171
Q

What are the attachments of the hamstring portion of the adductor magnus?

A
  • Ischial tuberosity -> Adductor tubercle
172
Q

What is the action of the adductor magnus?

A
  • Adduction and flexion of the thigh
173
Q

What gives innervation to the muscles of the medial thigh and what is the exception?

A
  • Obturator nerve
  • Hamstring of AM = Tibial Sciatic
174
Q

What are the muscles of the posterior compartment of the thigh?

A
  • Semimembranous
  • Semitendinosus
  • Biceps femoris (LH and SH)
175
Q

What are the attachements of the semimembranosus?

A
  • From ischial tuberosity -> medial surface of tibial condyle
176
Q

What is the action of the semimembranosus muscle?

A
  • Flexion of leg
  • Extension of thigh
  • Medial rotation
177
Q

What are the attachements of semitendonosus?

A
  • From ischial tuberosity -> Medial tibial surface
178
Q

What is the action of the semitendonosus muscle?

A
  • Flexion of leg
  • Extension of thigh
  • Medial rotation
179
Q

What are the two different parts of the bicep femoris?

A
  • Long head
  • Short head
180
Q

What are the attachments of the biceps femoris?

A
  • LH from ischial tuberosity
  • SH from linea aspera
  • Together they form a tendon
181
Q

What is the action of the biceps femoris muscle?

A
  • Main action is flexion at the knee
  • Also extends thigh at hip and laterally rotates at hip and knee
182
Q

Which nerve innervates muscles of the posterior thigh and what is the exception?

A
  • Tibial part of Sciatic nerve
  • SH = common fibular of sciatic
183
Q

What is the location of the femoral triangle?

A
  • Wedge-shaped area
  • Within superomedial aspect of anterior thigh
184
Q

What are the contents of the femoral triangle?

A
  • Femoral nerve/vein/artery/canal
185
Q

What are the different borders of the femoral triangle?

A
  • Roof - Fasica lata
  • Floor - Pectineus, iliopsoas, AL
  • Superior - inguinal ligament
  • Lateral - Sartorius
  • Medial - Adductor longus
186
Q

What is the hallmark feature of NOF fractures?

A
  • Leg is shortened and externally rotated
187
Q

What is the surgical management of a displaced subapital NOF fracture?

A
  • Hip arthroplasty
188
Q

What is the surgical management for an inter-trochanteric or basocervical NOF fracture?

A
  • Dynamic hip screw or IM nail
189
Q

What is the surgical management for an intracapsular or non-displaced NOF fracture?

A
  • Cannulated hip screw
  • Inverted triangle
190
Q

What is the surgical management for a sub-trochanteric NOF fracture?

A
  • Anterograde intramedullary femoral nail
191
Q

What are some complications associated with a NOF fracture?

A
  • Joint dislocation
  • Aseptic loosening
  • Peri-prothetic fracture
  • Deep infection
192
Q

What is the one year mortality associated with a NOF fracture?

A
  • Up to 30%
193
Q
A

Year 2 Medicine @ Lancaster Uni (15 decks)

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