49. Femur and hip Flashcards
3 main compartments of thigh
- Anterior
- Medial
- Posterior
Blood supply to femoral head and neck
medial and lateral circumflex
6 RFs for AVN of femoral head
- Steroids
- Chronic EtOH
- SCD
- Dysbarism
- HIV
- Trauma
Define Myositis ossificans
Patho bone formation
5 most common bone met primaries
breast, kidney, lung, thyroid, prostate
3 techniques to ID occult #s
- Shenton’s lines
- Normal and reverse S
- Trabecular lines
5 contraindications to tractions splints
- Pelvic #s
- Patella #s
- Knee ligament injuries
- tib or fib #s
- Open #
MGMT of avulsion #s
o ASIS and AIIS are conservative
o Ischial tuberosity more controversial
MGMT of non-displaced femoral neck #
1. Impacted 2 mgmt options • internal fixation • early ambulation 2. Unimpacted ORIF
MGMT of displace femoral neck #
ORIF
3 complications of femoral neck #
- AVN
- Deep infections
- PE
4 common other fractures that occur with intertroch #s
o distal radius
o proximal humerus
o rib
o lumbar
MGMT of intertroch #s
ORIF
MGMT of isolated greater or lesser troch #
WBAT
2 groups that get subtroch #s
o young with high energy
o elderly falls
MGMT of subtroch #
ORIF
complication of femoral #
fat emboli
2 things to consider in femoral shaft # with no good mech
- Pathologic
2. Abuse
MGMT of femoral neck stress #s
Compressive side
- Conservative with partial WBAT
Tension side
- Screw fixation
2 common #s to look for in hip dislocations
- Acetabular
2. Knee
Most common type of hip dislocation
posterior
What is main nerve to test in hip dislocation, and how
sciatic nerve
test extensor halluces longus
weak dorsiflexion
numb dorsum of foot
3 xray signs to assess hip #
- Position of lesser troch
- Size of femoral head
- Shenton’s lines
Time to reduce hips #
6 hours