Exam 1: Hip and Pelvis

Question 1

What are three goals of fracture treatment

Answer 1

1. Restore and heal fx to optimal functional state
2. Prevent complications
3. Rehab as early as possible

Question 2

What are the 4 different treatment options for a hip facture

Answer 2

ORIF
arthroplasty
hemiarthroplasty
non-surgical

Question 3

What type of treatment would you expect to see for a fracture of the femoral head or neck

Answer 3

arthroplasty

Question 4

What type of treatment would you expect to see for a fracture of the femoral head only

Answer 4

hemiarthroplasty

Question 5

If a non surgical approach to a hip fracture is done, what interventions will be done

Answer 5

Buck’s traction which is skeletal traction followed by the use of a cast brace

Question 6

What does rehab look like operative vs non-operative for a hip fracture

Answer 6

op: rapid

non; slow

Question 7

What is the risk of joint stiffness operative vs non-operative for a hip fracture

Answer 7

op: low
non: present

Question 8

What is the risk of a mal-union operative vs non-operative for a hip fracture

Answer 8

op: low
non: present

Question 9

What is the risk of non-union operative vs non-operative for a hip fracture

Answer 9

op: present
non: present

Question 10

What is the speed of healing operative vs non-operative for a hip fracture

Answer 10

op: slow
non: rapid

Question 11

What is the risk of infection operative vs non-operative for a hip fracture

Answer 11

op: present
non: low

Question 12

Clinically, when is a fx of the upper limb of a child healed

Answer 12

3-4 weeks

Question 13

Clinically, when is a fx of the upper limb of an adult healed

Answer 13

6-8 weeks

Question 14

Clinically, when is a fx of the lower limb of a child healed

Answer 14

6-8 weeks

Question 15

Clinically, when is a fx of the lower limb of an adult healed

Answer 15

12-16 weeks

Question 16

Radiologically, when is a fracture considered healed

Answer 16

when a bridging callus formation occurs which signals remodeling

Question 17

Biomechanically, when is a fracture considered healed

Answer 17

when there is a complete bony union

Question 18

The (superficial/deep) branch of the femoral artery terminates at the ____ fossa

Answer 18

deep, popliteal

Question 19

What are the advantages of external fixation

Answer 19

1. minimal blood loss
2. Early ambulation and exercise
3. Easy access for wound care

Question 20

What is the disadvantage of external fixation

Answer 20

infection of hardware can lead to osteomyelitis

Question 21

What are the symptoms of osteomyelitis and how is it treated

Answer 21

fever, swelling, erythema

may require IV antibiotics for weeks

Question 22

What are typical MOI’s for pelvic fractures

Answer 22

compression/blunt force, high speed collision, falls, and direct blows

Question 23

What are the two most common injury sites of a pelvic fx

Answer 23

anterior pubis and anterior ischium

Question 24

What are 5 possible sequela from pelvic fractures

Answer 24

1. Rupture of femoral artery
2. Nerve damage to sacral plexus
3. Sacroiliac pain
4. Hip joint disruption
5. damage to genitourinary structures

Question 25

A _____ is when the ball of the femur is replaced with a prosthesis

Answer 25

hemi-arthroplasty

Question 26

It is estimated by age 80, ___% of women will fx a hip

Answer 26

20

Question 27

By age ___, 20% of women will fx a hip

Answer 27

80

Question 28

___ ___ causes the greatest number of deaths and lead to the most severe health problems and reduced quality of life

Answer 28

hip fractures

Question 29

Most patients with a hip fx are hospitalized for about ___ ___. Up to 25% of older adults remain institutionalized for at least ___ ___.

Answer 29

1 week; 1 year

Question 30

What are common MOI's for hip fx

Answer 30

compression trauma, direct lateral impact to the hip during a collision or fall

Question 31

What are the three most common sites of injury of a hip fx

Answer 31

neck of femur, intertrochanteric and subtrochanteric

Question 32

What are the associated risks of a hip fx

Answer 32

soft tissue damage, and hemorrhage

Question 33

What are the associated risks of a pelvic fx

Answer 33

damage to blood vessels and organs that could result in peritonitis, sepsis, infection, hemorrhage, and shock

Question 34

Hip fx occur in the ___ of the femur and are usually due to a decrease in ___ ___ ___.

Answer 34

neck; bone mineral density

Question 35

True or False: Blood supply to the head of the femur is not compromised during a hip fx

Answer 35

false, it is because the head is intracapsular

Question 36

(the majority/very few) patients return to full mobility following a fx of the femoral neck

Answer 36

very few

Question 37

What type of fx is very common in the elderly

Answer 37

subcapital fracture

Question 38

how is a subcaptial fx treated

Answer 38

with pinning or partial hip replacement

Question 39

Why are subcapital fractures complicated in the young

Answer 39

due to the force required to fracture and can lead to AVN