Hip and pelvic fractures Flashcards

1
Q

What are hip fractures?

A

Fractures to the femoral neck

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2
Q

Who most commonly fractures the hip?

A

Over 60
Females

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3
Q

What is a possible cause of hip fracture in younger patients?

A

High energy trauma (e.g. car crash)

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4
Q

What are some factors that increase risk of hip fracture?

A
  • Osteoporosis
  • Smoking
  • Malnutrition
  • Excess alcohol
  • Neurological impairment
  • Impaired vision
  • Low BMI
  • Age (Increased fall risk)
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5
Q

What are the 2 main types of hip fracture?

A

Extra-capsular
Intra-capsular

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6
Q

What are the 2 main types of extra-capsular fracture?

A

Sub-trochanteric fracture
Trochanteric fracture

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7
Q

What are the 3 types of trochanteric fracture?

A

Basicervical
Intertrochanteric
Reverse oblique

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8
Q

What is meant by a sub-trochanteric fracture?

A

Fractures found below the lesser trochanter

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9
Q

What is meant by a trochanteric fracture?

A

Fractures found between the lesser and greater trochanter

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10
Q

What is meant by an intra-capsular fracture?

A

Fractures found between trochanters and femoral head

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11
Q

What type of fracture is shown by the red line?

A

Basicervical

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12
Q

What type of fracture is shown by the yellow line?

A

Intertrochanteric

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13
Q

What type of fracture is shown by the green line?

A

Reverse oblique

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14
Q

What are the two types of intra-capsular fracture?

A

Sub-capital
Trans-cervical

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15
Q

What is shown by the yellow line?

A

Sub-capital

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16
Q

What is shown by the green line?

A

Trans-cervical

17
Q

How will hip fracture usually present?

A

Inability to bear weight
Pain in hip

18
Q

What investigations are required in hip fracture?

A

Thorough history
ECG
Blood tests
X-ray
MRI or CT if unsure

19
Q

What will X-ray show in hip fracture?

A

Broken Shenton’s line

20
Q

What is Shenton’s line?

A

This is a smooth line following the superior pubic ramus, then down to the femoral shaft

21
Q

What are the 3 questions asked to determine surgical management of hip fractures?

A
  • Is it intra- or extra- capsular?
  • Is it displaced?
  • What is the function and comorbidities of the patient?
22
Q

What surgery is performed in displaced, high function, intra-capsular hip fracture?

A

Total hip replacement

23
Q

What surgery is performed in undisplayed, high function, intra-capsular hip fracture?

A

Compression hip screw

24
Q

What surgery is performed in low function, intra-capsular hip fracture?

A

Hemi-arthroplasty

25
What surgery is performed in inter-trochanteric, extra-capsular hip fracture?
Dynamic hip screw
26
What surgery is performed in sub-trochanteric, extra-capsular hip fracture?
Intra-medullary nail
27
What is important about fractures to a ring structure?
They very rarely break in only one place (Imaging trying to break a polo mint in only one place)
28
What are some types of pelvic fracture?
Open book fracture Pubic ramus fracture
29
What is shown on this X-ray?
Open book fracture (Pubic symphysis opened)
30
What is shown on this X-ray?
Right sided pubic ramus fracture
31
What classification system is used for pelvic fracture?
Young-Burgess classification
32
What is the first aid management of pelvic fracture?
First aid management is a pelvic binder, which applies pressure to prevent opening or blood loss into the pelvic cavity This also helps with pain
33
How are pelvic ramus fractures and other stable, undisplayed fractures managed?
Conservatively, using pain relief and physiotherapy
34
How are unstable, displaced or fractures in young patients usually managed?
ORIF
35