Fractures of the Hip and Proximal Femur Flashcards Preview

The Musculoskeletal System > Fractures of the Hip and Proximal Femur > Flashcards

Flashcards in Fractures of the Hip and Proximal Femur Deck (22):
1

Fractures of the proximal femur are more common in which sex?

Females

(mainly due to higher levels of osteoporosis)

2

Fractures of the proximal femur are common in young people associated in ________ _________ accidents

High energy

3

Risk factors for proximal femoral fractures include what?

  1. Age
  2. Osteoporosis
  3. Smoking
  4. Malnutrition
  5. Alcohol
  6. Neurological impairment
  7. Impaired vision

4

Which vessels supply the femoral head?

  1. Intramedullary artery
  2. Medial and lateral circumflex braches of profunda femoris
  3. Vessel of ligamentum teres

5

What are the two categories of proximal femoral fractures?

  1. Intracapsular
  2. Extracapsular

6

What is the danger of intracapsular fractures of the femur?

The blood vessels may not be intact and blood supply may be lost to the femoral head

7

Whar are the two main types of intracapsular proximal femoral fractures?

  1. Undisplaced
  2. Displaced

8

The Garden classification system describes which types of fractures?

Intracapsular femoral fractures

9

What is a Garden type 1 fracture?

An incomplete, stable fracture with impactation in valgus

10

What is a Garden type 2 fracture?

A complete but not displaced fracture with no disturbance of the medial trabecular lines

11

What is a Garden type 3 fracture?

A completely displaced fracture with varus and all 3 trabecullae disturbed

12

What is a Garden type 4 fracture?

A completely displaced fracture that is completely displaced

(the femoral head is aligned correctly in the acetabulum)

13

What are the three types of extracapsular fractures?

  1. Basicervical fractures
  2. Intertrochanteric fractures
  3. Subtrochanteric fractures

14

What are the two main complications of intracapsular femoral fractures?

  1. AVN
  2. Non-union

15

What are the two main complications of extracapsular femoral fractures? 

  1. Malunion
  2. Non-union

16

With fractures involving the proximal femur, which X-ray sign is indicative of a fracture?

Shenton's line

(it is a broken curve in fracture)

17

What is essential in dertermining whether a fracture is intra or extracapsular?

Lateral X-ray

(ALWAYS ask for one)

18

Which investigations are most utiliased for a proximal femoral fracture?

  1. X-ray (AP and lateral)
  2. MRI

19

If an intracapsular femoral fracture is undisplaced what is the treatment?

Fix the fracture and leave the femoral head

Nail

Dynamic hip screw and plate

20

If a patient is old and has a intracapsular femoral fracture which is displaced, what is the treatment?

Hip replacement

(or hemiarthroplasty for low demand patients)

21

Is a patient is young and they have a displaced proximal femoral fracture that is intracapsular, what is the treatment?

Fix the fracture and leave the femoral head#

Nail

Dynamic hip screw and plate

(this does no always work, but is worth trying due to patient age and likelihood of success)

22

Extracapsular femoral fractures, for the most part, always ______

Heal

(a dynamic hip screw can be used)

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