Femoral Neck Fractures Flashcards Preview

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Flashcards in Femoral Neck Fractures Deck (13):
1

What is the most expensive fracture to treat on a "per-person" basis?

femoral neck fxs
US has highest incidence
Women>men
Whites>blacks

2

What is the incidence of femoral neck fxs in femoral shaft fxs?

6-9%
Fix femoral neck, then femoral shaft

3

What is the normal neck shaft angle for the femur and normal anteversion?

neck-shaft angle: 130 +/- 7
Anteversion: 10 +/- 7

4

What imaging modality can help identify occult femoral neck fractures?

MRI

5

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

6

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%

7

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

8

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

9

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

10

What is the most significant determinant of post-op survival after a femoral neck fx?

Pre-op mobility
1-yr mortality is 14-36%; normal for age thereafter
2-yr mortality with CRF is ~45%

11

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

12

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

13

What injury is anticipated to have a 20% chance of mortality and 50% chance of loss of independence at one year when sustained by an 85-year-old female?

femoral neck fracture