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Musculoskeletal > Hip fractures > Flashcards

Hip fractures Flashcards

1
Q

Who?

A

>60

F>M

Young adults = high energy trauma

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2
Q

Risk factors?

A

Risk doubles every 10 years after age 50

Osteoporosis (3x more common in females)

Smoking

Malnutrition

Excess alcohol (decreases bone health)

Neurological impairment (inc fall risk)

Impaired vision

Low BMI

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3
Q
A

1 = Femoral head

2 = Femoral neck

3 = Greater trochanter

4 = Lesser trochanter

5 = Fovea

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4
Q

Types of hip fracture?

A

Intra and extracapsuler

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5
Q

Extracapsular?

A

Trochanteric

Sub- trochanteric

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6
Q

Intracapsular?

A

Displaced

Undisplaced

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7
Q

When is AVN risk higher?

A

Intracapsular fractures

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8
Q

Blood supply to femoral neck

A

Intramedullary artery of shaft of femur

Medial & lateral circumflex branches of profunda femoris

Artery of ligamentum teres

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9
Q

Symptoms?

A

Pain

Unable to life, move, rotate leg.

Unable to stand or put weight on leg.

Brusing and swelling around hip.

Injured leg appearing shorter than other.

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10
Q

Which way does injured leg turn?

A

Outwards

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11
Q

Does hip fracture always prevent from standing or walking?

A

No

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12
Q

History?

A

Mechanical fall

secondary to other causes (blackout, CVA, MI)

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13
Q

Relavent PMH conditions?

A

Diabetes

Bleeding disorders

CVD

Parkinsons

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14
Q

Physical examination?

A

Unable to weight bare/ pain

Congitive impairment?

Missed injuries?

Fluid status/ dehydration

Examination of limb

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15
Q

Examination of limb?

A

Neurology

Vascular status

May be shortened and externally rotated

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16
Q

Investigations?

A

ECG

Bloods

X-ray

If in doubt - MRI

17
Q

X-ray features?

A

Loss of contour of shentons line in neck of femur fracture

18
Q

When is MRI carried out?

A

If hip fracture suspected despite negative X-rays

19
Q

Management for intracapsular - high function hip fractures?

A

Displaced = THR

Undisplaced = CHS

20
Q

Management of low function intracapsuler hip fractures?

A

Hemiarthroplasty

21
Q

Management of intertrochanteric extracapsuler hip fractures?

A

DHS screw

22
Q

Management of subtrochanteric extracapsuler hip fractures?

A

IM nail

Musculoskeletal (12 decks)

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