Proximal Femur Fractures

Question 1

What percentage of patients with a proximal femur fracture are over the age of 60?

Answer 1

92%

Question 2

What gender is more at risk of proximal femur fractures?

Answer 2

Females (73%)

Question 3

What is usually the cause of proximal femur fractures in the young population?

Answer 3

high energy trauma

Question 4

What are the risk factors for a proximal femur fracture?

Answer 4

• Age (risk doubles every 10 yrs after turning 50)
• osteoporosis
• smoking
• malnutrition
• Excess alcohol
• neurological impairment
• impaired vision

Question 5

What is found between the two trochanters of the femur on the anterior side?

Answer 5

Intertrochanteric Line

Question 6

What is found between the two trochanters of the femur on the posterior side?

Answer 6

Intertrochanteric crest

Question 7

What muscles connect to the intertrochanteric line?

Answer 7

Vastus muscles (quads)

Question 8

Where does the hip capsule extend to on the anterior of the joint?

Answer 8

The intertrochanteric line

Question 9

Where does the hip capsule extend to on the posterior side of the joint?

Answer 9

Neck of the femur

Question 10

What blood vessels supply the femoral head?

Answer 10

• Intramedullary artery of shaft of femur
• Medial & lateral circumflex branches of profunda femoris
• Artery of ligamentum teres

Question 11

What are the two main types of proximal femur fracture?

Answer 11

Intracapsular and Extracapsular

Question 12

What type of fracture is at risk of avascular necrosis (AVN)?

Answer 12

Intracapsular

Question 13

What are the two subtypes of intracapsular proximal femur fractures?

Answer 13

undisplaced

displaced

Question 14

What are the 3 subtypes of extracapsular proximal femur fractures?

Answer 14

basicervical (@ base of the femoral neck)
intertrochanteric
subtrochanteric (below intertrochanteric line)

Question 15

What consequences can occur as a result of an unhealing intracapsular fracture?

Answer 15

• non-union

- AVN

Question 16

What two signs could indicate a displaced intra-capsular fracture?

Answer 16

shortening

external rotation

Question 17

What is Shenton’s line?

Answer 17

• Curved line from femur round to pubis

- Shows if femur is displaced from normal position

Question 18

What do you need to remember to do before taking a lateral X-Ray?

Answer 18

Flex other leg up to chest to allow X-Ray beams to penetrate the fractured hip

Question 19

If a fracture isn’t visible on both plain X-Rays what other test can be used to visualise it?

Answer 19

MRI

Question 20

What does an intracapsular fracture look like on a lateral X-Ray?

Answer 20

significant amount of femoral neck is attached to distal femur

Question 21

What does an extracapsular fracture look like on a lateral X-Ray?

Answer 21

Significant amount of femoral neck is attached to proximal femoral head

Question 22

How do you treat an undisplaced intracapsular fracture

Answer 22

Screw fixation

Question 23

How is a displaced intracapsular fracture managed?

Answer 23

Hemiarthroplasty

or THR if still active

Question 24

What device can be used to pin an extracapsular fracture?

Answer 24

Intra-medullary device