Ortho - Fractured neck of femur

Question 1

What are the causes of fractured neck of femur?

Answer 1

Osteoporosis (older)
Trauma (younger)
Combination

Question 2

What are the key features of a NoF history?

Answer 2

Age
Comorbidity: resp/CVD/DM/cancer
Pre-injury mobility: independent/shopping/walking/sports
Social hx: relatives/stairs/EtOH

Question 3

Why is location of NoF fracture important?

Answer 3

Dictates whether blood supply is preserved

Question 4

What are the management options for NoF fracture?

Answer 4

Fix or replace depends on location/displacement and age

Question 5

What is the management for an undisplaced extracapsular NoF fracture?

Answer 5

Fix with plate and screws as minimal risk to blood supply (dynamic hip screw)

Question 6

What is the management for undisplaced intracapsular NoF fracture?

Answer 6

Fix with screws - less risk to blood supply

Question 7

What is the management for displaced intracapsular NoF fracture?

Answer 7

Replace in older patients

Fix if young

Question 8

When might a total hip replacement be indicated?

Answer 8

Pt is younger
Walks a lot
Independent
Minimal comorbidities