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NYCC Bone & Joint > Hip Trauma > Flashcards

Hip Trauma Flashcards

1
Q

How must the patient be positioned in order to see hip trauma on a radiograph?

A

feet turned in 15 degrees

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2
Q

What is the most common cause of hip fractures?

A

minimal trauma in pt w/ osteoporosis

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3
Q

What sex experiences more intracapsular hip fractures?

A

females (5:1)

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4
Q

Name the 3 types of proximal intracapsular femoral fractures.

A
  • subcapital
  • midcervical
  • basicervical
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5
Q

What is the most common type of proximal intracapsular femoral fracture?

A

subcapital fx

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6
Q

Name the 3 types of proximal extracapsular femoral fractures.

A
  • trochanteric
  • intertrochanteric
  • subtrochanteric
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7
Q

What type of extracapsular proximal femoral fracture is always a pathologic fracture?

A

lesser trochanteric fx

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8
Q

What is the clinical significance of intracapsular proximal femoral fractures?

A

^incidence of:
- AVN (8-30%)
- non-union (25%)

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9
Q

What treatment is only used for intracapsular proximal femoral fractures?

A

total hip arthroplasty

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10
Q

Where do subcapital femoral fractures occur?

A

head-neck junction

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11
Q

What are the radiographic features of a subcapital femoral fracture?

A
  • disruption of cortex
  • zone of impaction
    (often difficult to see)
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12
Q

Why would avascular necrosis occur following a proximal femoral fracture?

A

disruption of lateral and/or medial femoral circumflex aa.

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13
Q

What are the radiographic characteristics of avascular necrosis?

A
  • sclerosis
  • flattening
  • fragmentation
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14
Q

What is the radiographic latent period for proximal femoral AVN?

A

up to 1 yr post-inj (but usually by 2-3 mo)

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15
Q

What is the most sensitive imaging modality for proximal femoral fractures?

A

MRI

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16
Q

What is the clinical significance of extracapsular proximal femoral fractures?

A
  • AVN & non-union are uncommon
  • surgical management
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17
Q

What is the most common hip disorder of adolescence?

A

SCFE

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18
Q

What is the clinical presentation of a SCFE?

A
  • hip pain referred to thigh & knee
  • trendelenberg gait (glute med weakness)
  • limited ABduction + internal rotation
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19
Q

What is the minimal diagnostic series for the hip?

A
  • AP (15 deg internal rotation)
  • frogleg
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20
Q

What are the radiographic findings of a SCFE?

A
  • decreased epiphyseal height
  • wide irregular growth plate
  • abnormal Klein line
  • metaphysis lateral to acetabulum
  • parrot beak appearance to head
  • pistol grip appearance to fem neck
21
Q

What line is abnormal in a patient with a SCFE?

A

Klein line

22
Q

What are the possible outcomes of a SCFE?

A
  • DJD (MC)
  • coxa vara deformity (<120 deg)
  • short, broad fem neck
  • AVN
23
Q

What is your next step for a patient with a SCFE?

A

refer to ortho

24
Q

What is the most common direction of a hip dislocation?

A

posterior (85%)

25
Q

What are the possible mechanisms of a posterior hip dislocation?

A
  • blow to knee w/ hip flexed & ABducted
  • blow to knee w/ hip flexed & ADducted
26
Q

What mechanism would cause a posterior hip dislocation with a posterior acetabular fracture?

A

blow to knee w/ hip flexed & ABducted

27
Q

What mechanism would cause a posterior hip dislocation without an acetabular fracture?

A

blow to knee w/ hip flexed & ADducted

28
Q

What is the mechanism of an anterior hip dislocation?

A

ABduction & external rotation of femur

29
Q

What is the radiographic appearance of an anterior hip dislocation?

A

femoral head lies near obturator

30
Q

What is the diagnosis?

A

Subcapital femoral Fx

31
Q

What is the mechanism of this diagnosis?

A

Blow to knee w/ hip flexion & ABduction
(Dx: post. Hip dislocation w/ post. acetabulum Fx)

32
Q

What is the diagnosis?

A

Subcapital femoral Fx

33
Q

What is the diagnosis?

A

Posterior hip dislocation

34
Q

What is the diagnosis?

A

Midcervical femoral fx

35
Q

What is the diagnosis?

A

Anterior hip dislocation

36
Q

What is the diagnosis?

A

Subtrochanteric fx

37
Q

What mechanism would cause this diagnosis?

A

Blow to knee w/ hip flexion & ADduction
(Dx: Posterior hip dislocation)

38
Q

What is the diagnosis?

A

Intertrochanteric fx

39
Q

What is the diagnosis?

40
Q

What is the diagnosis?

A

Basicervical femoral fx

41
Q

What is the diagnosis?

A

Subtrochanteric femoral fx

42
Q

What is the diagnosis?

A

Midcervical femoral fx

43
Q

What is the diagnosis?

A

Subtrochanteric fx

44
Q

What is the diagnosis?

A

Intertrochanteric fx

45
Q

What is the diagnosis?

A

Trochanteric Fx
(Greater)

46
Q

What is the diagnosis?

A

Basicervical femoral fx

47
Q

What is the diagnosis?

A

Trochanteric Fx
(Lesser)

48
Q

What is the diagnosis?

A

Midcervical femoral fx

NYCC Bone & Joint (52 decks)

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