Ortho

Question 1

Classification for supracondylar humeral fractures

Answer 1

Gartland
1 - undisplaced (/minimally displaced)
2 - displaced but with intact cortex
3 - completely displaced

Question 2

Classification for NOFF

Answer 2

Garden
Stage I – undisplaced, incomplete fracture
Stage II – undisplaced, complete fracture
Stage III – complete fracture, incompletely displaced
Stage IV – complete fracture, completely displaced

Question 3

How does hip fracture typically look O/E?

Answer 3

shortened, externally rotated leg

(fracturE - External)

remember which way that is to look at!

Question 4

How does hip dislocation typically look O/E?

Answer 4

shortened, internally rotated leg

(dIslocated - Internal)

remember which way that is to look at!

Question 5

Management of intracapsular hip fracture?

Answer 5

Depends on Garden classification:

• Garden 1-2 (not displaced): ORIF with screws or DHS (if weight bearing), or hemi-arthroplasty if non-weight bearing
• Garden 3-4 (displaced): replacement with THR or hemi-arthroplasty
• THR if: walk independently with no more than stick, not cognitively impaired, and medically fit for procedure and anaesthesia
• Otherwise: hemi

If <55: cannulated screw reduction and fixation is preferable to replacement
- monitor for AVN and replace if this develops

Question 6

Management of extracapsular hip fracture?

Answer 6

• Trochanteric (stable) – reduce and fix: DHS

- Subtrochanteric (stable) – reduce and fix: intermedullary nail