Clinical Correlations Flashcards
Where does a femoral neck fracture need to occur to be considered intracapsular?
Femoral head or neck inside the capsule
Where does a femoral neck fracture need to occur to be considered extracapsular?
Intertrochanteric or subtrochanteric outside of capsule
Typical clinical presentation of hip fracture
Hx fall Acutely shortened and externally rotated leg Hip or back pain Joint deformity Inability to bear weight
The action of which 2 muscles causes the clinical features of the leg ass. with hip fracture
Iliopsosas - flexing and externally rotating
Gluteus muscles - abducting and elevating
Which type of hip fracture is at increased risk for AVN and displacement of femoral head?
Intracapsular
Why are intracapsular fractures / femoral head displacement at increased risk of AVN?
Blood supply includes the retinacular arteries from the medial circumflex artery . Disruption means blood supply is only achieved by head of femur art. which is not enough blood.
Diagnostic features of intracapsular fractures
On xray: loss of shentons line, prominent lesser trochanter (due to ER of femur) , shortening/ angulation of the femoral neck
Diagnostic features of extracapsular fractures
On xray: fracture line either intertrochanteric or subtrochanteric
Pt with a recent hip fracture and cx of damaging sciatic N likely has what movements weak?
Knee flexion
Ankle dorsiflexion
Ankle plantar flexion
Most common hip dislocation
posterior
Mechanism of posterior hip dislocation
Forced flexion, IR and adduction
Mechanism of anterior hip dislocation
Extension and hyperabduction
Presentation of anteriorly dislocated hip
Shortening and ER
Presentation of posteriorly dislocated hip
Shortening and IR
Presentation of trochanteric bursitis
Hx of repetitive movemets
Chronic pain lateral thigh - point tenderness over greater trochanter, pain w resisted abduction
