Hip Fracture Flashcards Preview

PTRS 746 Exam 1 > Hip Fracture > Flashcards

Flashcards in Hip Fracture Deck (52):
1

Q: What is the approx. incidence of hip fractures per year?

329,000`

2

Q: What percent of hip fractures occur in women?

76

3

Q: 1 in ____ individuals die within 1 year of a hip fracture.

5

4

Q: 1 in _____ require nursing home care for at least 1 year.

4

5

Q: What percent of hip fractures result from falls?

90

6

Q: The risk of fracture ____________ every 5 years after the age of 50.

doubles

7

Q: The fracture rate of institutionalized individuals is _____x greater than those in the community.

5-11

8

Q: ________% of survivors fail to recover to prior functional status within 1 year of injury.

26-75

9

Q: Presence of a comorbidity increases mortality by ~____%.

16

10

Content: Intracapsular Hip Fracture (2)

1. Involve femoral head or neck

2. Higher rate of non-union and AVN

11

Content: 3 types of intracapsular fractures

1. Subcapital 2. Transcervical 3. Basicervical

12

Content: Extracapsular Hip Fracture (2)

1. Involve trochanteric region

2. Types trochanteric, intertrochanteric, subtrochanteric

13

Content: 4 Stages of the Garden Staging System

1 = incomplete, may be impacted

2 = complete, non-displaced

3 = complete, partially displaced

4 = complete, fully displaced

14

Q: Which stages of the Garden Staging System require surgery?

2-4, however, by the time we see them all the stages will look the same to us

15

Q: What are the steps in fracture management and which step involves PTs?

Steps: reduction, fixation, restoration of function PT = restoration of function

16

Content: 4 goals of fracture management

1. Pain control

2. Reduction and fixation in good position

3. Return to function

4. Prevent complications

17

Content: 3 indications for a conservative treatment plan for fracture management

1. Unstable medical status

2. Non-displaced fractures

3. Risk of surgery vs. risk of immobility

18

Content: 3 Surgical treatments for hip fracture

1. ORIF

2. HA

3. THA

19

Q: What 4 factors should be considered when hip surgery is an option?

1. Age

2. Mobility status

3. Mental state

4. Pre-existing bone and joint pathology

20

Q: ORIF or pinning is thought as _______ ___________.

bone conserving

21

Q: What is the failure rate of ORIF?

20-36%

22

Q: What population is ORIF suggested for?

Younger, highly active pts

23

Q: ORIF is the treatment of choice for _______________ fracture.

Extracapsular

24

Q: Hemiarthroplasty is considered for ______________ fracture.

Intracapsular

25

T/F: ORIF appears to have better outcomes than HA.

False, flip it

26

Q: What is the failure rate of HA?

6-18%

27

Q: What is the risk of dislocation with HA?

~5%

28

Q: With HA you see a deterioration of function after ______ years

3-5

29

T/F: With HA only the femoral component is replaced.

True

30

Term: Femoral head articulates with acetabulum, but is fixed to the stem

Unipolar

31

Term: Femoral head articulates with both acetabulum and stem

Bipolar

32

T/F: Bipolar replacements are better than unipolar replacements.

False, no evidence that one is better than the other

33

T/F: It is unclear whether cemented or uncemented is the superior approach.

True

34

Q: THA is considered for _______________ fracture

intracapsular

35

T/F: THA has better outcomes than HA beyond 3 years.

True

36

Q: What is the risk of dislocation for a THA?

5-10%

37

T/F: THA is never used to revise a failed ORIF or HA.

False, often

38

Content: Posterior THA precautions (3)

1. No ADD past neutral

2. No flexion past 90

3. No IR

39

Content: Anterior THA precautions (3)

1. No ABD

2. No (excessive) extension

3. No ER

40

Q: What are the 3 risks associated with posterior THAs?

1. Dislocation

2. Infection

3. DVT

41

Q: What are the 3 risks associated with anterior THAs?

1. Increased operative time

2. Increased blood loss

3. Infection

42

Content: Complications of hip surgery (8)

1. CV

2. Pneumonia

3. Pressure ulcers

4. Delirium

5. UTI

6. Wound infection

7. Depression

8. Malnutrition

43

Q: What is the single best predictor of operative mortality following hip fracture?

Delirium

44

Q: Acute delirium occurs in _________% of post-op pts.

30-50

45

Q: Delirium is usually observed within POD _____, resolved by POD ___.

1-5, 7

46

Content: DVT (3)

1. Very common complication of hip fracture

2. Incidence of up to 60% w/o prophylaxis

3. Incidence of 20-30% w/prophylaxis

47

Content: PE (3)

1. Incidence ~10-15%

2. Mortality ~2-10%  

3. Account for 14% of deaths due to hip fracture

48

Q: What is the key to rehab for hip fractures?

Early mobilization

49

Q: Delayed mobilizaiton is associated with... (5)

1. Delirium

2. Pneumonia

3. Increased length of stay

4. Greater 6 mo. mortality

5. Poorer 2 mo functional performance

50

T/F: The vast majority (90%) of hip fractures occur due to trauma.

False: falls

51

T/F: Falls are the leading cause of death in individuals greater than 65 years old.

True

52

Diagram: Risk factors for falls

A image thumb