T&O teaching 16/04

Question 1

Blood supply hip

Answer 1

• Off femoral artery –> profunda femoris
• –> branch to medial and lateral circumflex arteries
• Anastomose around femoral neck
• Ascending retinacular branches pierce capsule
• Cervical ring
• Ascending cervical supply femoral head

Question 2

What does hip # mean?

Answer 2

• Fractured NOF
• Not head or shaft or acetabulum

Question 3

What location is pain usually in hip #?

Answer 3

• Groin area

Question 4

Investigations for hip #

Answer 4

• ECG
• Urine drip
• Bloods - FBC, U&E, Group and save
• X-ray - AP pelvis inc both hips, lateral of affected hip

Question 5

Imaging sign of hip #

Answer 5

• Inferior and superior shenton line

Question 6

How to tell if leg is rotated in AP pelvis x-ray

Answer 6

• lesser trochanter more visible - usually posteromedial
• Rotates externally = revealed

Question 7

Problem with intracapsular # and reason why they have hip replacement

Answer 7

• Disruption to bloods supply
• = AVN and non-union
• So replace

Question 8

When to consider OR and internal fixation for intracapsular # instead of hemi/THR?

Answer 8

• If non-displaced - less risk blood supply OR
• Very young
• Can tolerate return to theatres if get AVN - try to preserve femoral head