Hip Fractures Flashcards
What are the major risk factors for hip fractures?
Age
Osteoporosis
Female > Male
How are hip fractures categorised?
Intra-capsular
Extra-capsular
Label the image
What type of blood supply does the head of the femur have?
Retrograde blood supply
Medial and lateral circumflex femoral arteries are 1 cm proximal to the intertrochanteric line
Why do patients with displaced intra-capsular fractures of the femur need to have hemiarthroplasty or total hip replacements?
Retrograde blood supply which can cause avascular necrosis if disrupted
What classification is used for intra-capsular nof fractures?
Garden classification
Grade I- incomplete and non-displaced
Grade II- complete and displaced
Grade III- complete and partially displaced
Grade IV- complete and completely displaced
Why can non-displaced intra-capsular fractures be treated with internal fixation?
May have intact blood supply
Internal fixation can hold head in place while fracture heals
Why do Grade III and IV fractures need head of femur removal and replacement?
Blood supply to the head of the femur is disrupted
When is total hip replacement offered?
To patients who can walk independently and fit for surgery
Why does the femoral head not need replacement in extra-capsular fractures?
Blood supply is intact
What are intertrochanteric fractures?
Fractures between the greater and lesser trochanters
How can an intertrochanteric fracture be treated?
Dynamic hip screw
Screw goes through neck and into head of femur
Plate with a barrel that holds the screw is screwed to outside of the femoral shaft
Where do subtrochanteric fractures occur?
Distal to the lesser trochanter (still within 5 cm)
Fracture occurs to the proximal shaft of the femur
How are subtrochanteric fractures treated?
Intramedullary nail
Metal pole inserted through greater trochanter into shaft
How do hip fractures typically present?
Groin or hip pain which radiates to the knee
Not able to weight bear
Shortened, abducted and externally rotated
What is Shenton’s line used for?
Disrupted in NOFF or Hip fractures
