[EMed] Hip Fractures Flashcards
what do pt with hip fractures present with?
shortened, externally rotated and flexed leg
what are hip fractures classified as?
- intracapsular
- extracapsular
what do intracapsular fractures at high risk of and why?
avascular necrosis (AVN) due to the retrograde blood supply
what does the Garden classification do?
classifies intracapsular fractures and whether it is displaced or non-displaced
what is the 1st line ix for hip fractures?
AP pelvis X-ray and lateral X-ray of affected hip
what is the mx for displaced intracapsular fracture if pt mobilises with a stick or better?
total hip replacement
what is the mx for displaced intracapsular fracture if pt doesn’t mobilise with a stick or better?
head-sparing surgery (DHS, cannulated screws etc.)
what is the mx for undisplaced intracapsular fracture?
hemiarthroplasty
what is the mx for intertrochanteric extracapsular fracture?
intramedullary nail
what is the mx for subtrochanteric extracapsular fracture?
extramedullary nail (DHS)
what are the risk factors for hip fracture?
- elderly
- “frequent fallers”
- osteoporosis
- high impact trauma
- post-menopausal women
what is done pre-op for hip fractures?
- analgesia + fascia iliaca block
- stop anticoagulants/anti-platelets
- early surgery
what is done post-op for hip fractures?
- thromboprophylaxis
- early mobilisation
- beware of delirium
what is Garden classification 1 for intracapsular fractures?
non-complete, non-displaced
what is Garden classification 2 for intracapsular fractures?
complete, non-displaced
