Fractures: Hip

Question 1

Features of hip #?

Answer 1

Pain
Shortened + externally rotated

Question 2

What hip # patients may still be able to WB?

Answer 2

Non-displaced or incomplete NOF #

Question 3

Define intracapsular vs. extracapulsar hip #?

Answer 3

Intracapsular: edge of femoral head to insertion of hip joint capsule

Extracapsular: either intertrochanteric or subtrochanteric

Question 4

Another word for intracapsular #?

Answer 4

Subcapital #

Question 5

Blood supply disruption is most common following what type of Garden fractures?

Answer 5

Types 3 and 4

Question 6

Mx of intracapsular hip #?

Answer 6

Undisplaced - IF or hemiarthroplasty if unfit
Displaced: THR or hemiarthroplasty if unfit

YOUNG PATIENTS:
Open repair with internal fixation and cancellous screws (as will wear out THR in lifetime)

Question 7

When is THR favoured over hemiarthroplasty in displaced hip # Mx?

Answer 7

Pt can walk independently with no more than stick
No cog impairment
Medically fit for anaesthesia/surgery

Question 8

Mx of extracapsular hip #?

Answer 8

Intertrochanteric + stable: dynamic hip screw
Subtrochanteric, transverse or oblique: intramedullary device