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Musculoskeletal > Hip and pelvic fractures > Flashcards

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
Q

What surgery is performed in inter-trochanteric, extra-capsular hip fracture?

A

Dynamic hip screw

26
Q

What surgery is performed in sub-trochanteric, extra-capsular hip fracture?

A

Intra-medullary nail

27
Q

What is important about fractures to a ring structure?

A

They very rarely break in only one place (Imaging trying to break a polo mint in only one place)

28
Q

What are some types of pelvic fracture?

A

Open book fracture
Pubic ramus fracture

29
Q

What is shown on this X-ray?

A

Open book fracture (Pubic symphysis opened)

30
Q

What is shown on this X-ray?

A

Right sided pubic ramus fracture

31
Q

What classification system is used for pelvic fracture?

A

Young-Burgess classification

32
Q

What is the first aid management of pelvic fracture?

A

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
Q

How are pelvic ramus fractures and other stable, undisplayed fractures managed?

A

Conservatively, using pain relief and physiotherapy

34
Q

How are unstable, displaced or fractures in young patients usually managed?

A

ORIF

35
Q
A

Musculoskeletal (123 decks)

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