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Flashcards in Images Viva Qs/Facts Deck (9)
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1
Q

Pathophysiology of hip fractures:

old vs young

A

Old= osteoporosis with minor trauma (e.g. fall)

Young = major trauma

2
Q

Osteoporosis RF

(Age + SHATTERED)

A

Age

Steroids

Hyper=para/thyroidism

Alcohol and cigarettes

Thin (BMI <22)

Testosterone low

Early menopause

Renal/liver failure

Erosive/inflame bone disease .e.g. RA, myeloma

Dietary Ca low/malabs, DM

3
Q

Presentation and key Qs for NOF#

(o/e and Qs)

A

Presentation

o/e: shortened externally rotated

Key Qs:

  • Mechanism
  • RF for osteoporosis/path #
  • Premorbid mobility
  • Premorbid independence
  • comorbidities
  • MMSE
4
Q

Initial Management of NOF#

A
  • Resuscitate: dehydration, hypothermia
  • Analgesia: M+M
  • Assess NV statur of lumb
  • Imaging: AP and lateral film
  • Prep for theatre:
    • inform anaesthetist and book theatre
    • bloods: FBC, U&E, clotting, x-match (2u)
    • CxR
    • DVT prophylaxis: TEDS, LMWH
    • ECG
    • Films: orthogonal x-rays
    • Get consent
5
Q

What to look for on imaging of a NOF#

A
  • Ask for AP and lat films
  • look at Shenton’s lines
  • Intra or extracapsular
  • displaces or non-displaced
  • osteopenic
6
Q

Key anatomy for NOF#

A
  • capsule attaches proximally to acetabular margin and distally to intertrochanteric line
  • blood supply to fem head:
    • retinacular vessels in capsule (distal to proximal)
    • Intramedullar vessels
    • artery of ligamentum teres

if retinacular vessels damaged there is a risk of AVN of fem head -> pain, stiffness and OA

7
Q

Classification of NOF#

A

Intracapsuar: subcapital, transcerical, basicervical

Extracapsular: intertrochanteric, subtrochanteric

Garden classification of intracapsular:

  1. incomplete #, undisplaced
  2. complete #, undisplaced
  3. Complete #, partically displaced
  4. Complete #, completely displaced
8
Q

specific complications of NOF# management

A

AVN of fem head in displaced # (30%)

Non/malunion (10-30%)

infection

OA

9
Q

Management of NOF#

A