Orthopaedics Lower Limb: Fracture Neck of Femur

Question 1

Aetiology Fractured Neck of Femur?

Answer 1

External Force - twisting while foot is fixed, a slip or being knocked over
Internal Force - collapse of bone due to osteoporosis, ischemia, or cancer

Question 2

Surgical Management for Undisplaced Intracapsular Fractures

Answer 2

Screws, as they seem to provide a better fixation than pins

Question 3

Surgical management for Displaced Intracapsular Fractures?

Answer 3

Arthroplasty, as it is associated with a lower re-operation rate than internal fixation

Question 4

Surgical Management for Extracapsular Fractures?

Answer 4

Sliding/Dynamic Hip Screw, as it gives better results than a fixed nail and plate

Question 5

Literature for physiotherapy for hip fractures suggests

Answer 5

Transfer training, ambulation training, assistive device prescription and training, ROM/strengthening exercises (bed/chair/standing). The focus is on early mobility in acute care to restore independent return to ADLs

Question 6

Why are older females at risk of hip fractures?

Answer 6

More likely to have osteoporosis due to causes such as menopause (you lose the protective hormones on the bone). Also, osteoporosis affects more than half of NZ women, men have a lower incidence

Question 7

In the year 2000, there were 9 million osteoporotic fractures, how many of those were hip fractures?

Answer 7

1.6 million

Question 8

What type of walking aids are commonly used after hip fractures?

Answer 8

2 wheel walking frames or 4 wheel walking frames. Crutches. Walking stick (minority)

Question 9

Falls are the

Answer 9

leading cause of hip fractures in older individuals

Question 10

What is the FRAXX tool?

Answer 10

The FRAXX tool calculates the 10-year probability of a fracture based on factors such as age, gender, BMI and co-morbidities. Need to be a minimum of 40 years of age

Question 11

Internal Fixation is an..?

Also explain the terms OPEN REDUCTION and CLOSED REDUCTION

Answer 11

Operation that involves the surgical implementation of implants for the purpose of repairing a bone. Internal fixators can include bone screws and metal plates, pins, rods, wires and intramedullary devices.
Open Reduction refers to open surgery to set bones as it is necessary for some fractures
Closed Reduction is a reduction without any open surgery, followed by internal fixation