Hip fracture and dislocation Flashcards
What is the mortality rate 1 year post hip fracture in elderly?
~30%
What are the types of hip fracture?
Instracapsular- femoral head, femoral neck
Extracapsular- intertrochanteric, trochanteric, subtrochanteric
Wh are hip fractures classically seen in?
Older patients, esp older women
What is the presentation of hip fracture?
Pain
History of fall typically
Short, abducted, externally rotated leg
What investigations are done for hip fracture?
XR
Determine cause if appropriate
Nerve exam- L5 and S1
What is the management of hip fracture?
Surgical
Conservative- rare, only if unfit for surgery
What surgery is done for intracapsular fracture?
HEmi or complete arthroplasty
When is a hemiarthroplasty done for intracapsular fracture?
Frail or inactive patient, limited life expectancy
When is a complete arthroplasty done for intracapsular fracture?
Displaced fracture, active patient
Lower risk of future dislocation
Why is an arthroplasty done for intracapsular fracture?
Risk of avascular necrosis
What is the management of an extracapsular hip fracture?
Intertrochanteric- dynamic hip screw
Sibtrochanteric- intramedullary screw
What are the complications of hip fracture?
Avascular necrosis
Sciatic nerve injury
Non union
When is avascular necrosis with fracture more common?
Intracapsular- due to medial circumflex artery that wraps around the NOF
When i non union more common?
Intracapsular fracture
Who is hip dislocation usually seen in?
Younger patients as a result of high impact injury