Chapter 99 - Fractures of the Hip Flashcards
what is the disadvantage of using a direct anterior approach to the hip for ORIF of a femoral neck?
you must also use a laterally based incision for all instrumentation/hardware
internervous plane for a watson-jones/anterolateral approach to the hip?
trick question both glute med and tfl are innervated by the superior gluteal nerve
mean femoral neck shaft angle?
130 +/- 7
mean femoral anteversion
10 +/- 7
trabecular bone patterns in the proximal femur are representative of what?
wolff’s law - bone remodels in response to stress
compression side, tension side and ward’s triangle - describe them
compression side - along calcar
tension side - along superior neck
wards triangle - weakest area of the femoral neck
what is the relationship between comorbidities and post-hip fracture one year mortality rate
4+ comorbidities = increased one year mortality rate compared to thos with three or fewer co-morbidities
how should a basicervical femoral neck be treated?
like an intertroch fracture - however they have less inherent rotational stability than an intertroch
- treat with a SHS and a detrotational screw
how to treat a femoral neck non-union
valgus intertroch osteotomy -> blade plate
instability in intertrochanteric fractures is based on what feature
posteromedial comminution -> tendency to fall into varus and retroversion
what are the surgical indications for greater trochanter fixation
> 1cm displacement in a young, active person
if you see an isolated lesser trochanter fracture, you should be thinking of what?
- ilipsoas avulsion if a kid
- pathologic fracture if an adult