W2

Question 1

How is a hip fracture typically managed surgically?

Answer 1

1. ORIF: cannulated screw and dynamic hip screw
2. Arthroplasty: can be total or hemi (pratial)

Question 2

Compare and contrast an intracapsular and extracapsular hip fracture?

Answer 2

Intracapsular
- within synovial capsule
- managed by hemiarthroplasty
- more complications
Extracapsular
- outside joint capsule
- managed by ORIF
- Include intertrochanteric and subtrochanteric fractures

Question 3

What is the physiotherapy management of hip fractures post hip replacement?

Answer 3

1. prevent: post op complications
   - early mobilisation
   - post surgical complications
2. prepare for discharge
   - Avoid SLR, rotation, unnecessary stress
   - consider movement restrictions

Question 4

What is the physiotherapy management of hip fractures post ORIF?

Answer 4

1. prevent
   - Post surgical completions
   - early mobilisations
2. prepare
   - No active hip flexion
   - Regain control in hip and knee
   - Avoid SLR, rotation, unnecessary stress

Question 5

Apply the fracture management principles to a hip fracture?

Answer 5

1. Reduce
2. Hold
   - ORIF
   - arthroplasty
3. Move
   - consider movement restrictions
   - move joints above and below (in this case below- knee and ankle)

Question 6

What is a DVT?

Answer 6

Blood clots that form in deep veins that slow down/block blood flow

Question 7

What are the warning signs of a DVT?

Answer 7

Pain on one side
Swelling in one side
Change in skin colour
Warmth in swelled area

Question 8

What are the risk factors for a DVT?

Answer 8

• Not moving for prolonged periods (late mobilisation)
• Post surgery
• Smoking
• Overweight
• Injury/trauma
• Family history
• Cancer
• Birth control
• Giving birth
• Older age

Question 9

What are the potential complications post THR?

Answer 9

Dislocation
periprosthetic fracture
Neurological (eg. Sciatic nerve palsy)
Vascular (DVT, PE)
Wound (dehiscence, infection)
Decreased cognitive function
Elderly and mobilisation
Increased chance of co morbidities

Question 10

What discharge options are there post THR?

Answer 10

1. Home with outpatient
2. inpatient
3. TCP
4. back to care facility (eg. nursing home)

Question 11

What are the movement precautions for a posterolateral THR?

Answer 11

Hip flexion past 90˚
Adduction
Internal Rotation

Question 12

What are the movement precautions for a anterolateral THR?

Answer 12

excessive hip extension
external rotation

Question 13

What approach is the highest risk of dislocation post THR?

Answer 13

posterolateral