NOF

Question 1

main blood supply to femoral head

Answer 1

MCFA (comes off femoral artery and then reticular arteries go up the nec to supply head in retrograde way)

Question 2

garden classficiation

Answer 2

1) incomplete
2) complete non displaced
3) complete partial displaced
4) complete fully displaced

Question 3

on Ex of NOF

Answer 3

externally rotated and shortened

Question 4

RF for NOF (normally fragility fracture)

Answer 4

female, LBW, falls

Question 5

Ix for NOF

Answer 5

AP and lateral Xray, CK if long lie, ECG, G+S, ECG to look for cause of fall

Question 6

types of extracapsular fracture

Answer 6

intertrochanteric and subtrochanteric (5cm distal to lesser trochanter)

Question 7

types of intracapsular fracture

Answer 7

displaced / non displaced

Question 8

Tx of non displaced intracapsular

Answer 8

cannulated hip screws

Question 9

Tx for displaced intracapsular

Answer 9

THR or hemiarthroplasty (this won’t last as long and function won’t be as good)

Question 10

Tx for subtrochanteric fracture

Answer 10

IM nail

Question 11

Tx for a intertrochanteric fracture

Answer 11

DHS

Question 12

criteria for a THR

Answer 12

no cog impairment and must be mobilising with no more than a stick

Question 13

other surgical considerations

Answer 13

abx and anticoagulant

Question 14

complications of THR

Answer 14

aseptic loosening, pain (need X-ray in both views at 6 weeks to check)
DVT, dislocation of the prosthesis