fractures hip treatment Flashcards

1
Q

3 types of hip fractures

A
  1. neck
  2. intertrochanteric
  3. sub trochal
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2
Q

3 main epi of hip fracture

A
  1. age
  2. metabolic bone disease
  3. falls
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3
Q

4 reasons hip can be a problem

A
  1. precarious blood supply
  2. delicate retinacular vessels
  3. art. cart. cover
  4. significanc force transmission
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4
Q

4 classes of hip fracture

A

Garden 1-4
1-2: relatively stable
3-4: unstable

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5
Q

2 main Sx

A
  1. PAIN!

2. inability to ambulate

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6
Q

4 signs

A
  1. if displaced -deformed
  2. short
  3. externally rotated
  4. guarding_+++
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7
Q

initial treatment

A
  1. admit
  2. apply skin traction
  3. optimize concurrent disesase
  4. plan surg
  5. rehab program
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8
Q

4 goals of surgery

A
  1. pain releif
  2. reduce deformity
  3. promote union
  4. early ambulation
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9
Q

when to use screw fixation

A
  • sub capital fractures
  • must not penetrate joint
  • non-union ca occur
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10
Q

when to use screw-plate fixation

A
  • inter and subtrochanteric fractures

- larger incision and blood loss

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11
Q

what is primary arthroplasty

A

joint replacment

  • definitive
  • early weight bearing
  • limited longevity
  • infection risk
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12
Q

4 indications for joint replacement

A
  1. displace subcapital - >70yo
  2. patho fracture due to tumor
  3. co-existant arthopathy
  4. head splitting fracture
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13
Q

2 types of replacements

A
  1. hemi - head and neck

2. total

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14
Q

4 local complications

A
  1. intra-operative injury
  2. infection
  3. non-union
  4. osteonecrosis
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15
Q

3 regional complicaitiokns

A
  1. DVT
  2. decubitus ulcers
  3. deformity ad stiffness
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16
Q

6 systemic complications

A
  1. pulmonary
  2. confusion
  3. PE
  4. UTI
  5. 10-15% mortality in year 1
  6. loss of indep.
17
Q

3 prosthetic complications

A

1/ dislocation

  1. loosening of prosthesis
  2. acetabular wear
18
Q

5 prognostic factors

A
  1. age
  2. quality of reduction
    3 severit of intial fracture
  3. fixation device
  4. general health
19
Q

4 prevention strategies

A
  1. bone loss preventions
  2. home safety
  3. walking aids
  4. special garments