Lower Limb fractures: Upper femoral Flashcards
Mechanism of injury of Fracture acetabulum
Force transmitted up the limb - can be from RTA, fall on the side and fall from a height
+/- hip dislocation
+/- Sciatic nerve injury
Management of Fracture of acetabulum if there is Minimal displacement or unstable
Minimal displacement - Conservative - bed rest and traction fro 6 weeks and NWB on cruthes
Unstable
-ORIF and NWB on crutches
What is a posterior dislocation hip
- Complications
- Management
Leg appears shorter internally rotated
Head on RTA
Complications
- Damage sciatic nerve
-AVN
-OA
Management
- Reduce/traction
-NWB/PWB up to 6/52
What is intracapsular upper femoral fracture
High fracture within capsule
Interrupt blood supply to the femoral head
What is extra capsular upper femoral fracture
Less difficult to treat as femoral head blood supply not compromised
Intracapuslar femoral neck and complications
Common in elderly - osteoporotic
Complications
AVN
Non union
Post op complications
Grade 1 or 2 Management intracapsular
It is undisplayed
Protected WB
Management of Garden 3 or 4 intracapsular
ORIF
- Pins or DHS
- NWB
-Usually for younger patient with little displacement
or
Prosthetic replacement
- PHR - Hemiarthroplasty
- A THR would be needed if there is damage of acetabulum
Extracapsular fractures definitions of
Inter trochanteric
sub trochanteric
Inter is between trochanters
Sub is below the trochanters
Blood supply not as compromised
What is fracture shaft of femur and complications
Spiral ,transverse of oblique fracture
Fluid and blood loos
Complications -Non union, malunion . fat embolism syndrome, infection or haemorrhage
What is continuous passive motion
allows early hip and knee movement post op
aims to prevent hip/knee stiffness
What is Fat embolism syndrome
