Proximal Femur Fractures Flashcards
What percentage of patients with a proximal femur fracture are over the age of 60?
92%
What gender is more at risk of proximal femur fractures?
Females (73%)
What is usually the cause of proximal femur fractures in the young population?
high energy trauma
What are the risk factors for a proximal femur fracture?
- Age (risk doubles every 10 yrs after turning 50)
- osteoporosis
- smoking
- malnutrition
- Excess alcohol
- neurological impairment
- impaired vision
What is found between the two trochanters of the femur on the anterior side?
Intertrochanteric Line
What is found between the two trochanters of the femur on the posterior side?
Intertrochanteric crest
What muscles connect to the intertrochanteric line?
Vastus muscles (quads)
Where does the hip capsule extend to on the anterior of the joint?
The intertrochanteric line
Where does the hip capsule extend to on the posterior side of the joint?
Neck of the femur
What blood vessels supply the femoral head?
- Intramedullary artery of shaft of femur
- Medial & lateral circumflex branches of profunda femoris
- Artery of ligamentum teres
What are the two main types of proximal femur fracture?
Intracapsular and Extracapsular
What type of fracture is at risk of avascular necrosis (AVN)?
Intracapsular
What are the two subtypes of intracapsular proximal femur fractures?
undisplaced
displaced
What are the 3 subtypes of extracapsular proximal femur fractures?
basicervical (@ base of the femoral neck) intertrochanteric subtrochanteric (below intertrochanteric line)
What consequences can occur as a result of an unhealing intracapsular fracture?
- non-union
- AVN
What two signs could indicate a displaced intra-capsular fracture?
shortening
external rotation
What is Shenton’s line?
- Curved line from femur round to pubis
- Shows if femur is displaced from normal position
What do you need to remember to do before taking a lateral X-Ray?
Flex other leg up to chest to allow X-Ray beams to penetrate the fractured hip
If a fracture isn’t visible on both plain X-Rays what other test can be used to visualise it?
MRI
What does an intracapsular fracture look like on a lateral X-Ray?
significant amount of femoral neck is attached to distal femur
What does an extracapsular fracture look like on a lateral X-Ray?
Significant amount of femoral neck is attached to proximal femoral head
How do you treat an undisplaced intracapsular fracture
Screw fixation
How is a displaced intracapsular fracture managed?
Hemiarthroplasty
or THR if still active
What device can be used to pin an extracapsular fracture?
Intra-medullary device