Hip Conditions Flashcards
What are major risk factors for hip fractures?
Age
Female
Osteoporosis
What are the 2 types of hip fracture?
Intracapsular
Extracapsular
Describe the blood supply to the head of the femur
Retrograde blood supply
The medial and lateral circumflex femoral arteries join the femoral neck just proximal to the intertrochanteric line
Why is a fracture of the intracapsular neck of the femur clinically relevant?
Damages the blood vessels causing avascular necrosis (AVN)
What is the pathology of AVN?
- Coagulation of intraosseous microcirculation
- Venous thrombosis
- Retrograde arterial occlusion
- Intraosseous HTN
- Reduced blood flow to femoral head
- Cell death
- Bone becomes soft
- Chondral fracture and collapse
What is the treatment of an intracapsular fracture?
Hemiarthroplasty- replace head of femur but leave acetabulum
Total hip replacement
What are the features of extracapsular fractures?
Leave blood supply intact
What is the typical presentation of a hip fracture?
Pain in groin of hip which may radiate to knee
Not weight bearing
Shortened, abducted, externally rotated leg
What views are an x ray taken in for hip fracture?
AP and lateral
What is trochanteric bursitis?
Inflammation of the bursa over the greater trochanter on the outer hip
What are some causes of bursitis?
Friction from repetitive movements
Trauma
Inflammatory conditions
Infection
What is the presentation of trochanteric bursitis?
Gradual onset lateral hip pain- radiates down outer thigh
Pain on walking
Pain lying on side
Tenderness over greater trochanter
What is the treatment of bursitis?
Rest
Ice
NSAIDs
Physio
Steroid injections
Bursectomy
What is FAI?
Femoroacetabular impingement- extra bone forms on femur and/or acetabulum
What are the 2 types of FAI?
Cam lesion- femoral based
Pincer- acetabulum based
