TBL Flashcards
What are the risk factors for hip fractures? Which gender is this more common in?
Risk Factors: falls, osteoporosis, multiple medical conditions
More common in women.
Explain the bimodal incidence of hip fractures.
Happens to the young, high energy traumas.
Happens to the elderly: white skinny alcoholics & smokers.
What are the 3 main categories of “hip” fractures?
Intracapsular Fractures
Extracapsular Fractures
Subtrochanteric Fractures
What are the types of intracapsular fractures?
femoral head
subcapital femoral neck
transcervical femoral neck
What are the types of extracapsular fractures?
basicervical femoral neck
intertrochanteric
greater & lesser trochanteric
Which artery supplies the majority of the weight-bearing surface of the femoral head?
lateral epiphyseal artery
If you have greater displacement of the femoral neck…you have greater disruption of what?
retinacular vessels
If you have a femoral neck fracture…which factors determine your treatment plan?
Age of patient
Displacement
Fracture Pattern
Ability to mobilize patient early
In elderly patients with femoral neck fractures…what are your goals for treatment?
Mobilize: minimize bedrest & get weight bearing again.
Minimize Surgery: safest surgery, decrease chance of reoperation.
In young patients with femoral neck fractures…what are your goals for treatment?
Spare femoral head
Avoid deformity
Minimize vascular injury
If you internally fix a femoral neck that is fractured…what is the reoperation rate?
18-47%
What are some types of intertrochanteric fractures?
Postermodial comminution
Reverse obliquity
Subtoch extension
Which type of fracture gives you a greater chance of maintaining blood supply to the femoral head: intracapsular fracture or extra capsular fracture?
extracapsular fracture
What is the one year mortality rate for hip replacements?
14-50%
What puts you at greater risk for mortality with a hip replacement?
Medical comorbidities Surgical delay > 3 days Mentally Challenged Arthroplasty Posterior approach to hip
