FN: Hip Fracture Flashcards
1
Q
Epi
A
80/100,000
50% in >80 yrs
F>M = 3:1
2
Q
Epi
A
80/100,000
50% in >80 yrs
F>M = 3:1
3
Q
Pathophysiology
A
Old = osteoporosis with minor trauma (e.g. fall) Young = major trauma
4
Q
Osteoporosis risk factors: Age + SHATTERED
A
Steroids
Hyper-para/thyroidism
Alcohol and Cigarettes
Thin (BMI
5
Q
Presnetation O/E
A
Shortened and externaly rotated Key Q's: 1. Mechanims 2. RF for osteoporosis/pathological fractures 3. Premorbid mobility 4. Premorbid independence 5. Cormorbidities 6. MMSE
6
Q
Initial Management
A
- Resuscitate: dehydration, hypothermia
- Analgesia M+M
- Assess: AP and lateral films
- Prep for theatre
7
Q
Prepping for theatre
A
Inform Aneasthetist and book theatre Bloods: FBC, U+E, clotting, X-match (2u) CXR DVT prophylaxis: TEDS, LMWH ECG Films: orthogonal X-rays Get consent
8
Q
Imaging
A
Ap and latweral fimls Look @ Shentons lines Intra or extra capsular Displaced or nondisplaced Osteopaenic
9
Q
Key Anatomy
A
- Capsule attaches proximally to acetabular margin and distaly to intertrochanteric line
- Blood supply to femoral head
- Retinacular vessels, incapsule, distal - proximal
- Intramedullary vessels
- Artery of ligamentum teres - If retinacular vessels damaged there is risk of AVN of the femoral head - pain, stiffness and OA
10
Q
Classification
A
Intracapsular: subcapital, transcervical, basicervical
Extracapsular: Intertrochanteric, subtrochanteric
11
Q
Classification
A
Garden classification
12
Q
Garden Classification of intracapsular Fractures
A
- Incomplete fractures undisplaced
- Complete fractures undisplaced
- Complete fracture partially displaced
- Complete fracture completely displaced
13
Q
Surgical Management Intracapsular 1,2
A
1,2: ORIF with cancellous screws
14
Q
Intracapsular Mx 3,4:
A
15
Q
Pathophysiology
A
Old = osteoporosis with minor trauma (e.g. fall) Young = major trauma
