Hip Flashcards
What pathologies may cause shortening of the lower limb?
Severe OA
Perthes Disease
SUFE
Avascular Necrosis
Hip Fracture
What may cause avascular necrosis?
Idiopathic
Alcohol abuse
Steroids
Hyperlipidaemia
Thrombophillia
How does avascular necrosis present on an x-ray?
Classically causes ‘hanging rope’ sign.
May lead to femoral head collapse.
How can avascular necrosis be treated?
If prior to collapse, drill holes into the femoral neck.
If collapse has already occurred, then total hip replacement is needed.
What is trochanteric bursitis?
A condition caused by considerable strain upon the broad tendinous insertion of the abductor muscles.
How is trochanteric bursitis treated?
Analgesics
Anti-inflammatories
Physiotherapy
Steroids
How does a hip fracture typically present?
Pain
Shortened leg
Externally rotated leg
Important to note that ability to weight bear can vary greatly.
In which area does an intracapsular fracture occur?
From the edge of the femoral head to the insertion point of the hip joint capsule.
What are the 2 types of extracapsular hip fracture?
Trochanteric
Subtrochanteric
What scoring system can be used to classify hip fractures?
Garden system
In which levels of Garden fracture will there be disruption of the blood supply?
Type 3 and 4
How should an intracapsular, undisplaced fracture be managed?
Internal fixation
If unfit, hemiarthroplasty.
How should a displaced intracapsular fracture be managed?
THR is recommended.
If unfit, hemiarthroplasty.
What factors may predispose to hemiarthroplasty over THR in displaced intracapsular fracture?
Poor mobility
Cognitive impairment
Not fit for surgery
How is a stable intertrochanteric fracture treated?
Dynamic hip screw
