Hip Fractures

Question 1

Risk factors of Hip#?

Answer 1

Osteoporosis (pooki ostekhan)
Smoking
Excess Alcohol
Low bone health=High falls risk

Question 2

Surgical anatomy of the femour?

Answer 2

Question 3

Other words that use for hip #?

Answer 3

Femoral neck fracture
Neck of femur fractures (NOF)
Proximal femur fracture

Question 4

Main aetiology of hip #?

Answer 4

Over 60 yrs old
Female

Question 5

Hip # classifications

Answer 5

intracapsular
extracapsular

Question 6

The types of intracapsular #?

Answer 6

subcapital
transcervical fractures

Question 7

Intracapsular fractures can damage ——— artery

Answer 7

the medial femoral circumflex artery

Question 8

What is Garden classification?

Answer 8

Intracapcular fractures are classified using the Garden classification - predicts union (healing in the expected time) and risk of AVN, which influences treatment, but we don’t have this in intracapsular

Question 9

The types of extracapsular #?

Answer 9

basicervical
intertrochanteric
Reverse oblique
subtrochanteric

Question 10

Where does intracapsular # occur in the femur?

Answer 10

Occur proximal to the intertrochanteric line
Involve the femoral head and neck

Question 11

Clinical presentations of hip #?

Answer 11

Symptoms (the things patient says)

• Hip/groin pain
• May be swelling
• Unable to weight bear

Signs (you find out by examining)

• Lower limb on affected side may be shortened and externally rotated
• Assess neurology and vascular status of the lower limb
• Assess for cognitive impairment
• Assess for any missed injuries
• Assess for dehydration (some patients may have been on the floor for a long time)

Question 12

What is Shenton’s line in hip x-ray?

Answer 12

It is formed by medial edge of the femur and inferior edge of the superior pubic ramus.
Loss of contour of Shenton’s line in pelvic x-ray indicates hip fracture
Fractures to femoral neck do not always cause loss of Shenton’s line

Question 13

What are the investigations for hip #?

Answer 13

Xray

MRI
- Some undisplaced fractures are subtle/invisible on x-ray
- Where clinical suspician persists patients undergo either a repeat x-ray after 10 days or an immediate MRI

Others
- ECG
- Bloods

Question 14

What are displaced and undisplaced?

Answer 14

Question 15

3 questions that confirm to have surgical management?

Answer 15

Is it Intra/Extracapsular?
Is it displaced/undisplaced?
What is the function/comorbidities of patient?