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3. Hip And Thigh > Neck Of Femur Fracture > Flashcards

Neck Of Femur Fracture Flashcards

1
Q

What are the two ways you can get a #NOF

A

Low energy injures such as old people failing over

High energy injuries such as road traffic accident/ fall from a height

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2
Q

What are the two distinct areas that you can get a #NOF

A

Intra-capsular

Extra-capsular

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3
Q

what are the two regions within the extra-capsular region

A

Inter-trochanteric

Sub-trochanteric

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4
Q

Which artery predominantly supplies the femoral head

A

Medial cicumflex femoral artery

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5
Q

Which fracture causes avascular necrosis of the femoral head

A

displaced intra-capsular fractures disrupt the blood supply to the femoral head and, therefore, the femoral head will undergo avascular necrosis

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6
Q

What is the management of avascular necrosis of the femoral head

A

joint replacement

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7
Q

How can intracapsular fractures be classified

A

Using the garden classification for intracapsular hip fractures

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8
Q

What is garden 1

A

Non displaced, incomplete fracture

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9
Q

What is garden 2

A

Non displaced, complete fracture

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10
Q

What is garden 3

A

Complete fracture but partial displacement

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11
Q

what is garden 4

A

Complete fracture fully displaced

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12
Q

What are the clincal features of someone with #NOF

A

Pain sometimes can be referred to the knee

Inability to bear weight

Shortened and externally rotated

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13
Q

What are the differential diagnoses of NOF fracture

A

Pubic Ramus fractures

acetabulum, femoral head and femoral diaphysis

Pathological fractures - eg due to bone disease etc

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14
Q

What imaging investigations should be carried out

A

Plain radio graphic imaging - AP views and lateral views of affected hip

AP pelvis

Full length femoral radiographs

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15
Q

What blood tests should be ordered

A

FBC

U&Es

COAG

Group and save

Creatinine kinase - for rhabdo

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16
Q

What is the management of #NOF

A

A to E assessment to deal with any life threatening issues first

Adequate analgesia - opioids/ regional local anaesthetic

Definitive management is surgery

17
Q

What are the immediate post op complications

A

Pain

Bleeding

Leg length discrepancies

And potential neurovascular damage

18
Q

What are the log term complications

A

joint dislocation, aseptic loosening, peri-prosthetic fracture, and deep infection/prosthetic joint infection. The mortality following a femoral neck fracture is up to 30% at one year.

19
Q

What are the surgical options available to pts

A

Hip hemi-arthroplasty

Dynamic hip screw

Cannulated hip screws

Intra-medullary femoral nail

3. Hip And Thigh (3 decks)

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