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Junior Surgery- Trauma and Orthopaedics > Hip > Flashcards

Hip Flashcards

1
Q

Outline the anatomy of the hip joint.

A

Acetabulum and labrum with head of femur

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2
Q

Outline the vasculature of the hip joint.

A

Supplied by profunda femoris- medial and lateral circumflex arteries anastomose, forming a circle around the femur

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3
Q

What ligaments support the hip joint?

A
  • Iliofemoral (Strongest) - Ischiofemoral (Posterior) - Pubofemoral (Anterior-inferior) - Ligament of head of the femur (carrying artery of head of the femur/acetabular branch of obturator artery)
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4
Q

What normally causes hip #s in the elderly?

A

Osteroperosis + minor trauma

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5
Q

What normally causes hip #s in the younger Pt?

A

Trauma

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6
Q

What are the risk factors for osteoperosis?

A

Age + Shattered

Steroids

Hyperthy/parathy

Alcohol/smoking
Thin (BMI<22)
Testosterone low
Early menopause
Renal/liver disease
Erosive bone disease e.g. myeloma
Diet (Low Ca, malabsorption)

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7
Q

What are the key questions in the history?

A
  • Mechanism
  • Risk factors
  • Baseline level of activity and mobility
  • Co-morbidities
  • MMSE
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8
Q

What imaging is used in hip #s?

A

XR- AP and lateral films

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9
Q

What is Shenton’s Line?

A
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10
Q

What should you look for on XR?

A
  • Intra vs extra capsular
  • Displaced or non-displaced
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11
Q

How does a hip # present?

A
  • Pain
  • Inbility to WB
  • History of trauma/low impact injury
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12
Q

What are the signs of a hip #?

A

Shortened, externally rotated limb

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13
Q

What bloods should be done?

A
  • UsEs- rhabdomyolysis
  • Coag Studies
  • Cross match 2 units
  • FBC- platelets
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14
Q

Why might a urine dip or CXR be useful?

A

Cause of injury

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15
Q

Outline Garden classification.

A

​INTRACAPSULAR ONLY

  1. Incomplete #
  2. Complete #, undisplaced
  3. Complete #, partially displaced
  4. Complete #, fully displaced (much of the way)
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16
Q

What other XRs should you have?

A
  • AP Pelvis
  • Full length femoral
17
Q

What is the initial management?

A

RAN
Resuscitation

Analgesia

NV examination

18
Q

How are they surgically managed by Garden classification?

A

1/2 ORIF with cancellous screws

3/4

  • <55yo- ORIF with screws, arthroplasty if AVN
  • 55-75/active THR
  • 75+/inactive Hemiarthroplasty
19
Q

When is a girdlestone indicated?

A

Usually a temprorary measure:

  • Failed arthroplasty
  • Failed fixation
20
Q

What are the complications of a hip fracture?

A
  • AVN- medial circumflex
  • Mortality 30% at one year
  • NV Damage
  • Post-op
    • Bleed
    • Infection (including prostheses)
    • Metalwork prominence
21
Q

How is an extracapsular # surgically treated?

A

DHS (Dynamic Hip Screw)

22
Q

What does a DHS look like on XR?

Junior Surgery- Trauma and Orthopaedics (7 decks)

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