23,24 hip fractures ( femoral neck and intertrochanteric), intracapsular fracture of femoral neck

Question 1

What are the intracapsular hip fractures?

Answer 1

Femoral head Femoral neck

Question 2

What are the types of femoral neck fractures?

Answer 2

Subcapital Transcervical Basicervical

Question 3

What are the extracapsular hip fractures?

Answer 3

Trochanteric Subtrochanteric

Question 4

What are the types of femoral trochanteric fractures?

Answer 4

Intertrochanteric Pertrochanteric

Question 5

What is the classification for femoral head fractures?

Answer 5

Pipkin classification:
I → below fovea (not involving weight bearing surface) II → above fovea (involving weight bearing surface)
III → type I or II + femoral neck fracture
IV → type I or II + acetabular rim fracture

Question 6

What is the treatment for a pipkin I fracture?

Answer 6

Closed reduction if possible
ORIF with small subarticular screws if closed reduction is not possible

Question 7

What is the treatment for a pipkin II fracture?

Answer 7

ORIF

Question 8

What is the treatment for a pipkin III fracture?

Answer 8

Young:
ORIF, then internal fixation of femoral head Old:
Prosthetic replacement

Question 9

What is the treatment for a pipkin IV fracture?

Answer 9

the femoral head fracture, even if nondisplaced, should be internally fixed

Question 10

What is the classification for femoral neck fractures?

Answer 10

Garden classification
I → Incomplete stable fracture with impaction in valgus II → Complete fracture and non displacement
III → Complete fracture with partial displacement
IV → Complete fracture with complete displacement

Question 11

What is the classification for femoral intertrochanteric fractures?

Answer 11

Evans Jensen classification IA → 2 part non-displaced IB → 2 part displaced
IIA → 3 part with separate greater trochanter fragment
IIB → 3 part with separate lesser trochanter fragment III → 4 part fracture

Question 12

What is a sign of hip fracture?

Answer 12

Shortening of the affected limb and external rotation.

Question 13

What are the complications of femoral head fractures?

Answer 13

Femoral head necrosis Non union

Question 14

How can a femoral neck fracture be treated?

Answer 14

Prosthetic joint replacement
Place screws in the femoral head and neck

Question 15

What are the exceptions in which patients may undergo internal fixation despite the high risk of avascular necrosis?

Answer 15

Young patient with long lifespan Poor surgical candidates
Short lifespan