Hip and knee disorders Flashcards
What are the two categories for hip fractures
intra and extra capsular
What is the type of blood supply to the head of femur?
retrograde blood supply
What is the arterial supply of the head of femur?
Branches of the medial and lateral circumflex arteries
What is the management of displaced intracapsular fracture?
hemiarthroplasty or total hip replacement
Which classification is used for intracapsular NOF?
Garden classification- grade I-IV
Discuss the criteria for each Garden classification grade
Grade I – incomplete fracture and non-displaced
Grade II – complete fracture and non-displaced
Grade III – partial displacement (trabeculae are at an angle)
Grade IV – full displacement (trabeculae are parallel)
Which type of NOF is internal fixation used for?
non-displaced (grade I and II) as they may have intact blood supply to femoral head therefore femoral health can be preserved without AVN
Hemiarthroplasty is used in the management of which type of NOF grade?
Grade II-IV
What is hemiarthroplasty?
replacement of the head of femur with acetabulum in place
(total= socket + head femur)
What is the surgery for intertrochanteric fracture?
dynamic hip screw = sliding hip screw
Lateral and medical circumflex arteries branch off from which artery?
deep femoral artery
What is the surgery for subtrochanteric fractures?
intramedullary nail
Other than mechanical fall, list three reasons why someone may present with NOF
Anaemia
Electrolyte imbalances
Arrhythmias
Heart failure
Myocardial infarction
Stroke
Urinary or chest infection
Which view can you observe Shenton’s line?
AP
What is the timeframe for operating on hip fractures?
48 hours
Aside from surgery, list three aspects of management of NOF
analgesia
venous thromboembolism risk
orthogeriatrics
physio- mobility
A 27 year old man complains of a painful and swollen right knee after injuring the joint during a tackle whilst playing football.
Meniscal tear
Collateral ligament injury
Cruciate ligament injury
Proximal tibia/tibial plateau fracture
Extensor mechanism injury including patella fracture, patella or quadriceps tendon rupture
Patient with acute haemarthrosis of the knee with absence of any fractures, What is the likely diagnosis?
ACL rupture
Two tests for ACL?
Lachman’s
Anterior drawer test
What is Osgood Schattler’s disease?
Osgood-Schlatter disease is caused by inflammation at the tibial tuberosity where the patella ligament inserts. It is a common cause of anterior knee pain in adolescents.
What is the pathophysiology of osgood schlatter’s disease?
multiple minor avulsion fractures occur where the patella ligament pulls away tiny pieces of the bone. This leads to growth of the tibial tuberosity,
What is meralgia paraesthetica?
compression of lateral femoral cutaneous nerve causing sensory symptoms only
Which movement of hip exacerbates meralgia paraesthetica?
extension of the hip
