(1,3) Hip Trauma Flashcards
(48 cards)
How must the patient be positioned in order to see hip trauma on a radiograph?
feet turned in 15 degrees
What is the most common cause of hip fractures?
minimal trauma in pt w/ osteoporosis
What sex experiences more intracapsular hip fractures?
females (5:1)
Name the 3 types of proximal intracapsular femoral fractures.
- subcapital
- midcervical
- basicervical
What is the most common type of proximal intracapsular femoral fracture?
subcapital fx
Name the 3 types of proximal extracapsular femoral fractures.
- trochanteric
- intertrochanteric
- subtrochanteric
What type of extracapsular proximal femoral fracture is always a pathologic fracture?
lesser trochanteric fx
What is the clinical significance of intracapsular proximal femoral fractures?
^incidence of:
- AVN (8-30%)
- non-union (25%)
What treatment is only used for intracapsular proximal femoral fractures?
total hip arthroplasty
Where do subcapital femoral fractures occur?
head-neck junction
What are the radiographic features of a subcapital femoral fracture?
- disruption of cortex
- zone of impaction
(often difficult to see)
Why would avascular necrosis occur following a proximal femoral fracture?
disruption of lateral and/or medial femoral circumflex aa.
What are the radiographic characteristics of avascular necrosis?
- sclerosis
- flattening
- fragmentation
What is the radiographic latent period for proximal femoral AVN?
up to 1 yr post-inj (but usually by 2-3 mo)
What is the most sensitive imaging modality for proximal femoral fractures?
MRI
What is the clinical significance of extracapsular proximal femoral fractures?
- AVN & non-union are uncommon
- surgical management
What is the most common hip disorder of adolescence?
SCFE
What is the clinical presentation of a SCFE?
- hip pain referred to thigh & knee
- trendelenberg gait (glute med weakness)
- limited ABduction + internal rotation
What is the minimal diagnostic series for the hip?
- AP (15 deg internal rotation)
- frogleg
What are the radiographic findings of a SCFE?
- decreased epiphyseal height
- wide irregular growth plate
- abnormal Klein line
- metaphysis lateral to acetabulum
- parrot beak appearance to head
- pistol grip appearance to fem neck
What line is abnormal in a patient with a SCFE?
Klein line
What are the possible outcomes of a SCFE?
- DJD (MC)
- coxa vara deformity (<120 deg)
- short, broad fem neck
- AVN
What is your next step for a patient with a SCFE?
refer to ortho
What is the most common direction of a hip dislocation?
posterior (85%)
