Hip Fractures Flashcards
what group of people are hip fractures most often seen in
92% cases in >60s, 73% females
how can young people suffer hip fractures
from high energy trauma
what risk factors are associated with hip fractures
increasing age, osteoporosis, smoking, malnutrition, excess alcohol, neurological impairment, low BMI
describe how age is associated with hip fracture risk
risk doubles every 10 years after 50
describe the anatomical position of intracapsular hip fractures
proximal to greater and lesser trochanter, but distal to femoral head
(femoral neck more or less)
describe the anatomical position of extracapsular hip fractures
distal to line from greater to lesser trochanter, up to 5cm below lesser trochanter
describe the blood supply to the femoral head
intramedullary artery of shaft of femur, medial + lateral circumflex branches of profunda femoris, artery of ligamentum teres
in terms of blood supply what is the difference between intra and extracapsular hip fractures
intracapsular cuts of blood supply to femoral head, whereas extracapsular doesn’t
what problem can intracapsular fractures result in the femoral head
avascular necrosis(AVN)
what different types of intracapsular fractures are there
subcapital or transcervical, can both be either displaced or undisplaced
describe the difference between a subcapital and transcervical hip fracture
subcapital much closer to femoral head, transcervical in the middle of the femoral neck
what classification is used for intracapsular hip fractures
Garden I to IV, graded by size of fracture and displacement
what different types of extracapsular hip fractures are there
basicervical, intertrochanteric, reverse oblique, subtrochanteric
describe where is a basicervical hip fracture
at the base of the femoral neck, just above the greater and lesser trochanters
describe where an intertrochanteric and subtrochanteric hip fracture is seen
intertrochanteric = going through the greater and lesser trochanters subtrochanteric = below lesser trochanter, at very proximal end of femoral shaft
what is looked for/seen in the physical examination of hip fracture patients
unable to weight bear, pain, cognitive impairment?, missed injuries fluid stats/dehydration, examination of limb
what is involved in the physical examination of the limb of a hip fracture patient
neurological status, vascular status, leg may be shortened and externally rotated
what bedside tests are done for hip fracture patients
ECG, bloods
what investigations are done to diagnose hip fracture
X-ray of pelvis and lateral hip, if in doubt MRI
describe what Shenton’s line is
an anatomical line formed by the medial edge of the femoral neck and the inferior edge of the superior ramus
what is the clinical relevance of Shenton’s line
loss of contour of the line is a sign pf neck of femur fracture
(although not always)
