Hip Fracture Flashcards
Risk factors? (8)
Elderly Osteoporosis Previous fractures Maternal Hx Corticosteroid use Trauma Smoking Low body weight
Presentation? (2)
Pain
Classic signs are a shortened and externally rotated leg
What is the severe complication risk?
Avascular necrosis
What are two main type of hip fracture classification?
Intrascapular (sub-capital)
Extrascapular
What is intrascapular (sub-capital)?
From the edge of the femoral head to the insertion of the capsule of the hip joint
What is extra scapular?
These can either be trochanteric or substrochanteric (the lesser trochanter is the dividing line)
Adduction + internal rotation = ?
Posterior dislocation – femoral neck fracture
Shortened, abducted, internally rotated = ?
Femoral head fracture
Short + externally rotated = ?
Intertrochanteric fracture
What grading system is commonly used?
The Garden System
Type I of the Garden system?
Stable fracture with impaction in valgus (a deformity involving oblique displacement of part of a limb away from the midline)
Type II of the Garden system?
Complete fracture but undisplaced
Type III of the Garden system?
Displaced fracture, usually rotated and angulated, but still has boney contact
Type IV of the Garden system?
Complete boney disruption
Blood supply disruption is common is which types?
Types III & IV
Mx of undisplaced intrascapular fracture? (2)
Internal fixation
OR
hemiarthroplasty (if unfit)
Mx of displaced intrascapular fracture in young & fit i.e. <70 years?
Reduction and internal fixation (if possible).
Mx of displaced intrascapular fracture in older and reduced mobility?
Hemiarthroplasty or total hip replacement.
Mx of extrascapular fracture?
If if reverse oblique, transverse or subtrochanteric?
Dynamic hip screw
Intramedullary device/rod/nail
