Proximal Femur Fractures - 7/11/18 Flashcards
What are risk factors for proximal femur fractures?
Risk doubles every 10 years after 50 Osteoporosis Female Smoking Malnutrition Excess alcohol Neurological impairement Impaired vision
What are the 7 important surgical anatomy points of the femur?
Femoral head Femoral neck Greater trochanter Intertrochanteric line Intertrochanteric crest Lesser trochanter Subtrochanteric region
What is the blood supply to the femoral head?
Intramedullary artery of shaft of femur
Medial and lateral circumflex branches of profunda femoris
Artery of ligamentum teres
What are two types of proximal femur fracture?
Intracapsular -Undisplaced -Displaced Extracapsular -Basicervical -Intertrochanteric -Subtrochanteric
What are complications of each type of proximal femoral fracture?
Intra -non-union -AVN Extra -malunion -non-union
How is a proximal femoral fracture diagnosed?
History Fall Pain Unable to weight bear Signs Shortening External rotation Investigations X-ray MRI
What investigations are done for proximal femur fractures?
X-ray
MRI
What is seen on X-ray in proximal femur fractures?
Shenton’s line
What are the 3 principles of hip fracture management?
Return patient to pre-fracture level of function
Usually by operation followed by mobilisation
Early mobilisation to avoid complications of recumbency
What is the treatment of an undisplaced intracapsular fracture?
Screws and Plate
What is the treatment of a displaced intracapsular fracture?
Hemi-arthroplasty
When should a full arthroplasty be used?
When the patient has high function
What is the treatment for extracapsular fractures?
Screws and Plates
Intramedullary devise
DHS
Gamma Nail
