MSK

Question 1

classification of hip fractures

Answer 1

Intracapsular: subcaptial, transcervical, basicervical

Extracapsular: intertrochanteric, subtrochanteric

Question 2

classification of hip fractures

Answer 2

Intracapsular: subcaptial, transcervical, basicervical

Extracapsular: intertrochanteric, subtrochanteric

Question 3

Garden Classification of hip fractures

Answer 3

I: incomplete fracture of femoral neck
II: complete fracture without displacement
III: complete fracture with partial displacement
IV: complete fracture with complete displacement

III + IV: have higher risk of avascular necrosis; more likely to replace the femur head during surgery

Question 4

Presentation of hip fracture

Answer 4

symptoms: severe pain, bruising, unable to weight bear
signs: shortened with external rotation

Question 5

pain management for hip fracture

Answer 5

medical: e.g. analgesia
mechanical: e.g. traction, splinting

Question 6

management of hip fracture

Answer 6

History + examination
ATLS assessment
- make sure they haven’t got any other injuries e.g. c spine; neurovascular status

XR pelvis/limb (AP + Lateral: 2 views, 2 joints), CT (head, old fractures), MRI (3rd line), bone scan
Routine bloods, group + save
ECG, CXR

Question 7

management of hip fractures

Answer 7

conservative: analgesia, bed rest, traction
- really not ideal!

surgical

• head sparing: screws, DHS
• head sacrificing: hemiarthroplasty, THR