Flashcards in Femoral Neck Fractures Deck (13):
What is the most expensive fracture to treat on a "per-person" basis?
femoral neck fxs
US has highest incidence
What is the incidence of femoral neck fxs in femoral shaft fxs?
Fix femoral neck, then femoral shaft
What is the normal neck shaft angle for the femur and normal anteversion?
neck-shaft angle: 130 +/- 7
Anteversion: 10 +/- 7
What imaging modality can help identify occult femoral neck fractures?
What is the advantage of THA over hemiarthroplasty in the treatment of a femoral neck fx?
1) more predictable pain relief
2) improved functional hip scores
3) lower re-operation rates
What is the 30-day mortality a/w femoral neck fractures?
If treated within 4 days from injury: 7.3%
Treated after 4 days: 10%
Acute medical comorbidity delaying surgery: 17%
Which cannulated screw configurations used in the treatment of subcapital femoral neck fractures is optimal?
Inverted triangle pattern with the inferior screw posterior to midline and adjacent to the calcar
4-screw configuration considered if posterior comminution
In a young patient that underwent ORIF for a displaced femoral neck fracture, what is the most common complication?
AVN or osteonecrosis (10-45%)
Can treat with either free vascularized fibular graft or THA
Which type of malreduction is a/w failure of ORIF in femoral neck fractures?
Varus; can lead to non-union
Treated with valgus intertrochanteric osteotomy
What is the most significant determinant of post-op survival after a femoral neck fx?
1-yr mortality is 14-36%; normal for age thereafter
2-yr mortality with CRF is ~45%
What is the Timed Up and Go test useful for?
Indicates probability of independent walking without assistive device at 2-yr f/u after a femoral neck fx
In patients with femoral neck fractures that present to the hospital 2-3 days after injury, what procedure should be added to pre-operative work up?
Duplex US of lower extremities
Higher risk of DVT with long immobilization