hip fracture Flashcards
what is the blood supply to the femoral head?
- medial femoral circumflex artery
2. artery to the ligamentum teres
what is the risk of displaced hip fractures and why?
avascular necrosis
blood supply to femoral head runs up the neck
what are the features of hip fracture?
- pain
- shortened and externally rotated leg
- pts with non-displaced/incomplete neck of femur # may be able to weight bear
what is the classification of hip fractures?
- intracapsular (subcapital)
2. extracapsular
what does an intracapsular hip fracture mean?
from the edge of the femoral head to the insertion of the capsule of the hip joint
what does an extracapsular hip fracture mean?
either trochanteric or subtrochanteric (the lesser trochanter is the dividing line)
what is the classification system commonly used for hip fractures?
Garden system
what are the components of the Garden system?
Type I: stable # with impaction in valgus
Type II: complete # but undisplaced
Type III: displaced #, usually rotated and angulated, but still has bony contact
Type IV: complete bony disruption
in which Garden system types is blood supply disruption most common?
Types III and IV
what is the treatment for undisplaced intracapsular fracture?
internal fixation
hemiarthroplasty if unfit
what is the treatment for displaced intracapsular fracture?
replacement arthroplasty (total hip replacement or hemiarthroplasty)
when is a total hip replacement favoured to hemiarthoplasty?
if pts are:
- able to walk independently out of doors with no more than the use of a stick
- not cognitively impaired
- medically fit for anaesthesia and the procedure
what is the treatment for extracapsular hip fracture?
dynamic hip screw
what is the treatment of extracapsular hip fracture if it is reverse oblique / transverse / subtrochanteric?
intramedullary device
