Neck of Femur Fracture Flashcards
What are the risk factors of NOF #?
Age bc osteoporosis + increased risk of falls
Why do the elderly have increased risk of falls? (4 things)
- Neurovasc lesions
- Medications
- Dehydration
- Cognitive impairment
How are NOF # classified? (2 things)
- Intra-capsular
- Extra-capsular
Where is the # in intra-capsular NOF #? (3 parts)
In these parts of the NOF:
- Subcapital
- Transcervical
- Basocervical
What are the 2 types of extra-capsular NOF #?
- Inter-trochanteric (greater –> lesser trochanter)
- Sub-trochanteric (from lesser trochanter and down 5cm)
What classificiation system is used to classify Intra-capsular NOF #s?
Garden Classification
What is the Garden Classification System for Intra-capsular NOF #s? (4 things)
- Non-displaced, incomplete #
- Non-displaced, complete #
- Partially displaced, complete #
- Fully displaced, complete #
How do intra-capsular #s disrupt blood supply to femoral head? (2 points)
- Blood supply to NOF is retrograde (passes distally -> proximally from neck to head)
- Blood supply is thru medial circumflex femoral artery (lies on intra-capsular femoral neck)
What can an intra-capsular NOF # lead to?
What will this therefore require?
AVN
Requires arthroplasty (replacement) NOT fixation
What are the clinical features of NOF #s? (3 things)
- Pain
- Inability to weight bear
- Leg shortened + ext. rot. @ examination
Where is the pain in NOF #s? (3 things)
- Groin
- Thigh
- Referred to knee (elderly)
What scans should be done for suspected NOF #? (2 things)
- AP + Lat XR of affected hip
- AP Pelvic XR
Why is an AP Pelvic XR done in suspected NOF #?
To assess normal hip for pre-op planning + templating
What tests should be done for suspected NOF #? (7 things)
- FBC
- U&Es
- Coag screen
- G&S
For elderly
- Urine dip
- CXR
- ECG
What is the initial management for NOF #? (3 things)
- Morphine (pain relief)
- IV fluids (rehydration / maintain hydration whilst starved)
- Thromboprophylaxis